Outcome predictors in nonoperative management of newly diagnosed subacromial impingement syndrome: a longitudinal study.

Abstract

OBJECTIVE:

This prospective investigation is designed to determine the prognostic factors associated with the response to conservative therapy of subacromial impingement syndrome.

MATERIALS AND METHODS:

We treated 102 patients with subacromial impingement syndrome, diagnosed by physical examination and a subacromial lidocaine injection test, with a standardized conservative protocol. We followed the patients for a period of 12 months. Outcome was evaluated with Constant score and effects of 8 variables: Age, sex, pretreatment symptom duration, dominant shoulder, initial Constant score, active range of motion, acromion morphology, and acromial spur on patient outcomes were evaluated with univariate and multivariate analyses.

RESULTS:

Among 89 patients (44 men; mean age, 56.4 years) who finished the study, the mean difference between initial and final scores was 15.9 (95% confidence interval [CI]: 13.9-17.8). Three variables, the initial Constant score (b = .52, 95% CI: .28-.76), the duration of disease before treatment (b = -4.4, 95% CI: from -7.2 to -1.6), and acromial morphology (b = -5.3, 95% CI: from -9.8 to -.8) were found to be independent predictors of outcome (model R2 = .68).

CONCLUSION:

Patients with more severe disease, a long duration of symptoms, and type II or III acromion may require more invasive therapeutic options as the first intervention.

• Authors: Afsin Taheriazam, Mohsen Sadatsafavi, Alireza Moayyeri
• Journal: MedGenMed : Medscape general medicine (MedGenMed) Vol. 7 Issue 1 Pg. 63 (Feb 14 2005) ISSN: 1531-0132 [Electronic] United States
• PMID: 16369368 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Anti-Inflammatory Agents, Non-Steroidal
• Indomethacin

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Female
• Humans
• Indomethacin (therapeutic use)
• Longitudinal Studies
• Male
• Middle Aged
• Physical Therapy Modalities
• Prognosis
• Shoulder Impingement Syndrome (diagnosis, therapy)
• Treatment Outcome