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Effect of an education and activation programme on functional limitations and patient-perceived recovery in acute and sub-acute shoulder complaints - a randomised clinical trial.

De Bruijn C, de Bie R, Geraets J, Goossens M, van den Heuvel W, van der Heijden G, Candel M, Dinant GJ - BMC Musculoskelet Disord (2007)

Bottom Line: Multilevel analysis failed to show a significant effect of the EAP on either functional limitations or patient-perceived recovery.The EAP has no significant effect on the outcome of SCs after 6 and 26 weeks.The relation between catastrophising at baseline and functional limitations suggests that an intervention focusing specifically on catastrophising may be more successful in reducing functional limitations in the long term.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute for Rehabilitation Research, PO box 192, 6430 AD, Hoensbroek, The Netherlands. cdbn@cbs.nl

ABSTRACT

Background: The education and activation programme (EAP) aims at coping with psychosocial determinants to prevent the development of chronic shoulder complaints (SCs). The effect of the EAP on functional limitations and patient-perceived recovery after 6 and 26 weeks is evaluated in a randomised clinical trial.

Methods: Patients with SCs present at rest or elicited by movement and lasting no longer than 3 months were allocated at random to either EAP as an addition to usual care (UC), or to UC only. Measurements were taken at baseline and after 6 and 26 weeks and were analysed by means of multilevel analysis for the group effect. EAP was administered by GPs or by an ambulant therapist (CDB). Patients in the UC group were given UC by their own GP.

Results: Multilevel analysis failed to show a significant effect of the EAP on either functional limitations or patient-perceived recovery. Analysis showed coincidentally a relation between catastrophising at baseline and functional limitations.

Conclusion: The EAP has no significant effect on the outcome of SCs after 6 and 26 weeks. The relation between catastrophising at baseline and functional limitations suggests that an intervention focusing specifically on catastrophising may be more successful in reducing functional limitations in the long term. Further research is however needed to evaluate the effect of catastrophising at baseline on the course of SCs.

Trial registration: Current Controlled Trials ISRCTN71777817.

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Figure 1: Flow chart.

Mentions: GPs referred a total of 133 patients for participation in the EAP trial, 74 of whom were actually included in the trial. In total, 64 patients responded to the advertisements. Of these, 44 met the selection criteria, as ascertained by a telephone interview. The subsequent visit by the EAP-GP resulted in the final inclusion of 37 patients. A total of 111 patients were thus eventually recruited to participate in the study (figure 1). Three patients dropped out after randomisation without receiving any treatment, and were therefore excluded from further analysis. After 6 weeks, complete data was available for 40 patients (77%) in the UC group and 48 patients (86%) in the EAP group. After 26 weeks, complete data was available for 35 patients (67%) in the UC group and 44 (79%) patients in the EAP group.


Effect of an education and activation programme on functional limitations and patient-perceived recovery in acute and sub-acute shoulder complaints - a randomised clinical trial.

De Bruijn C, de Bie R, Geraets J, Goossens M, van den Heuvel W, van der Heijden G, Candel M, Dinant GJ - BMC Musculoskelet Disord (2007)

Flow chart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2211478&req=5

Figure 1: Flow chart.
Mentions: GPs referred a total of 133 patients for participation in the EAP trial, 74 of whom were actually included in the trial. In total, 64 patients responded to the advertisements. Of these, 44 met the selection criteria, as ascertained by a telephone interview. The subsequent visit by the EAP-GP resulted in the final inclusion of 37 patients. A total of 111 patients were thus eventually recruited to participate in the study (figure 1). Three patients dropped out after randomisation without receiving any treatment, and were therefore excluded from further analysis. After 6 weeks, complete data was available for 40 patients (77%) in the UC group and 48 patients (86%) in the EAP group. After 26 weeks, complete data was available for 35 patients (67%) in the UC group and 44 (79%) patients in the EAP group.

Bottom Line: Multilevel analysis failed to show a significant effect of the EAP on either functional limitations or patient-perceived recovery.The EAP has no significant effect on the outcome of SCs after 6 and 26 weeks.The relation between catastrophising at baseline and functional limitations suggests that an intervention focusing specifically on catastrophising may be more successful in reducing functional limitations in the long term.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute for Rehabilitation Research, PO box 192, 6430 AD, Hoensbroek, The Netherlands. cdbn@cbs.nl

ABSTRACT

Background: The education and activation programme (EAP) aims at coping with psychosocial determinants to prevent the development of chronic shoulder complaints (SCs). The effect of the EAP on functional limitations and patient-perceived recovery after 6 and 26 weeks is evaluated in a randomised clinical trial.

Methods: Patients with SCs present at rest or elicited by movement and lasting no longer than 3 months were allocated at random to either EAP as an addition to usual care (UC), or to UC only. Measurements were taken at baseline and after 6 and 26 weeks and were analysed by means of multilevel analysis for the group effect. EAP was administered by GPs or by an ambulant therapist (CDB). Patients in the UC group were given UC by their own GP.

Results: Multilevel analysis failed to show a significant effect of the EAP on either functional limitations or patient-perceived recovery. Analysis showed coincidentally a relation between catastrophising at baseline and functional limitations.

Conclusion: The EAP has no significant effect on the outcome of SCs after 6 and 26 weeks. The relation between catastrophising at baseline and functional limitations suggests that an intervention focusing specifically on catastrophising may be more successful in reducing functional limitations in the long term. Further research is however needed to evaluate the effect of catastrophising at baseline on the course of SCs.

Trial registration: Current Controlled Trials ISRCTN71777817.

Show MeSH