McDevitt Amy W, Mintken Paul E, Cleland Joshua A, Bishop Mark D
Physical Therapy Program, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
Department of Physical Therapy, Franklin Pierce University, Manchester, NH, USA.
J Man Manip Ther. 2018 Jul;26(3):136-146. doi: 10.1080/10669817.2018.1432541. Epub 2018 Feb 16.
Retrospective cohort.
To examine general expectations for treatment by physical therapists and specific expectations for common interventions in patients with shoulder pain. A secondary objective was to assess the extent to which patients' general and specific expectations for treatment affect clinical outcomes.
We performed a secondary analysis of data from a clinical trial of interventions for shoulder pain. Prior to beginning treatment for shoulder pain, 140 patients were asked their general expectations of benefit and their specific expectations for individual interventions. Next we examined how these expectations related to the patients' ratings of the success of treatment at one and six months after treatment.
Patients had positive general expectations for treatment by a physical therapist. Specific manual therapy interventions of range of motion and strengthening had the highest proportion of patients who expected these interventions to significantly improve shoulder pain. Seventy-two patients (58%) reported themselves to be improved using the global rating of change (GROC) at one month and six months. In the full model predicting one-month GROC, only the expectation of moderate relief ( = 0.012) and body mass index (BMI) ( = 0.013) had significant effects. Overall, the Shoulder Pain and Disability Index (SPADI) significantly decreased over time ( = 0.004); however, a significant interaction did occur between time and BMI ( = 0.021).
Patients expect common interventions used by physical therapists to be effective to manage shoulder pain. In conclusion, patients with shoulder pain had high general expectations for physical therapy.
Prognosis, level 2b.
回顾性队列研究。
研究物理治疗师对治疗的总体期望以及对肩痛患者常见干预措施的具体期望。次要目的是评估患者对治疗的总体和具体期望对临床结局的影响程度。
我们对一项肩痛干预临床试验的数据进行了二次分析。在开始治疗肩痛之前，询问了140名患者对治疗益处的总体期望以及对个体干预措施的具体期望。接下来，我们研究了这些期望与患者在治疗后1个月和6个月对治疗成功的评分之间的关系。
患者对物理治疗师的治疗有积极的总体期望。特定的手动治疗干预措施，如活动范围和强化训练，期望这些干预措施能显著改善肩痛状况的患者比例最高。72名患者（58%）在1个月和6个月时使用总体变化评分（GROC）报告自己有所改善。在预测1个月GROC的完整模型中，只有中度缓解的期望（P = 0.012）和体重指数（BMI）（P = 0.013）有显著影响。总体而言，肩痛和功能障碍指数（SPADI）随时间显著下降（P = 0.004）；然而，时间和BMI之间确实存在显著的交互作用（P = 0.021）。
患者期望物理治疗师使用的常见干预措施对管理肩痛有效。总之，肩痛患者对物理治疗有很高的总体期望。
预后，2b级。
