Does the outcome of diagnostic ultrasound influence the treatment modalities and recovery in patients with shoulder pain in physiotherapy practice? Results from a prospective cohort study

Karel, YHJM; Miranda, A; Thoomes-de Graaf, M; Scholten-Peeters, GG; Ottenheijm, RP; Koes, BW; Verhagen, AP

Does the outcome of diagnostic ultrasound influence the treatment modalities and recovery in patients with shoulder pain in physiotherapy practice? Results from a prospective cohort study

Karel, YHJM Miranda, A Thoomes-de Graaf, M Scholten-Peeters, GG Ottenheijm, RP Koes, BW Verhagen, AP

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Publication Type:: Journal Article
Citation:: Musculoskeletal Science and Practice, 2019, 41 pp. 28 - 35
Issue Date:: 2019-06-01

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Field	Value	Language
dc.contributor.author	Karel, YHJM	en_US
dc.contributor.author	Miranda, A	en_US
dc.contributor.author	Thoomes-de Graaf, M	en_US
dc.contributor.author	Scholten-Peeters, GG	en_US
dc.contributor.author	Ottenheijm, RP	en_US
dc.contributor.author	Koes, BW	en_US
dc.contributor.author	Verhagen, AP https://orcid.org/0000-0002-6195-0128	en_US
dc.date.available	2021-08-12T19:01:05Z
dc.date.issued	2019-06-01	en_US
dc.identifier.citation	Musculoskeletal Science and Practice, 2019, 41 pp. 28 - 35	en_US
dc.identifier.issn	2468-8630	en_US
dc.identifier.uri	http://hdl.handle.net/10453/135118
dc.description.abstract	© 2019 Elsevier Ltd Study design: Prospective cohort study including patients with shoulder pain in primary care physiotherapy. Background: There is an increased tendency to use diagnostic ultrasound to aid the diagnostic strategy and target treatment. It is a relatively cheap and accessible imaging technique but the implications for practice and patients are unknown. Objectives: To study the influence of diagnostic ultrasound (DUS) on diagnostic work-up, treatment modalities and recovery. Methods: Participants (n = 389) with a new episode of shoulder pain were assessed at baseline and followed for 6, 12 and 26 weeks. Diagnostic work-up, including the use of DUS, and treatment strategies were reported by the therapists at 3, 6 and 12 weeks. Results: Most patients (41%) were diagnosed with subacromial impingement/pain syndrome after physical examination or DUS. DUS was used in 31% of the participants. Tendinopathy was the most found abnormality in this sub-population. Patients who underwent DUS were more frequently treated using exercise therapy. Patients that not had DUS were more likely to receive massage therapy, trigger point therapy or mobilisation techniques. Logistic regression analyses did not show a significant association between DUS and recovery after 26 weeks (0.88, 95%CI:0.50–1.57). Correcting for the therapist as a confounder using a multilevel binary logistic regression did not show a significant cluster effect. Conclusion: Diagnostic US as a work-up component does not seem to influence diagnosis or recovery but does influence the choice of treatment modality. Conclusions are limited to observational data. High quality randomized trials should study the effect of DUS on recovery.	en_US
dc.relation.ispartof	Musculoskeletal Science and Practice	en_US
dc.relation.isbasedon	10.1016/j.msksp.2019.03.003	en_US
dc.rights	info:eu-repo/semantics/embargoedAccess
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Cohort Studies	en_US
dc.subject.mesh	Disability Evaluation	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Follow-Up Studies	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Physical Therapy Modalities	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Shoulder Impingement Syndrome	en_US
dc.subject.mesh	Shoulder Pain	en_US
dc.subject.mesh	Tendinopathy	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Ultrasonography	en_US
dc.title	Does the outcome of diagnostic ultrasound influence the treatment modalities and recovery in patients with shoulder pain in physiotherapy practice? Results from a prospective cohort study	en_US
dc.type	Journal Article
utslib.citation.volume	41	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	open_access	*
pubs.publication-status	Published	en_US
pubs.volume	41	en_US

Abstract:

© 2019 Elsevier Ltd Study design: Prospective cohort study including patients with shoulder pain in primary care physiotherapy. Background: There is an increased tendency to use diagnostic ultrasound to aid the diagnostic strategy and target treatment. It is a relatively cheap and accessible imaging technique but the implications for practice and patients are unknown. Objectives: To study the influence of diagnostic ultrasound (DUS) on diagnostic work-up, treatment modalities and recovery. Methods: Participants (n = 389) with a new episode of shoulder pain were assessed at baseline and followed for 6, 12 and 26 weeks. Diagnostic work-up, including the use of DUS, and treatment strategies were reported by the therapists at 3, 6 and 12 weeks. Results: Most patients (41%) were diagnosed with subacromial impingement/pain syndrome after physical examination or DUS. DUS was used in 31% of the participants. Tendinopathy was the most found abnormality in this sub-population. Patients who underwent DUS were more frequently treated using exercise therapy. Patients that not had DUS were more likely to receive massage therapy, trigger point therapy or mobilisation techniques. Logistic regression analyses did not show a significant association between DUS and recovery after 26 weeks (0.88, 95%CI:0.50–1.57). Correcting for the therapist as a confounder using a multilevel binary logistic regression did not show a significant cluster effect. Conclusion: Diagnostic US as a work-up component does not seem to influence diagnosis or recovery but does influence the choice of treatment modality. Conclusions are limited to observational data. High quality randomized trials should study the effect of DUS on recovery.

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http://hdl.handle.net/10453/135118