Macfarlane G J, Hunt I M, Silman A J
Arthritis and Rheumatism Council Epidemiology Research Unit, School of Epidemiology and Health Sciences, University of Manchester, United Kingdom.
J Rheumatol. 1998 Aug;25(8):1612-5.
To determine the natural history of shoulder pain in the population, and predictors of outcome on the basis of clinical and individual factors. In addition, to determine whether outcome is influenced by the definition of shoulder pain used.
A prospective cohort study, over a 3 year period, of subjects recruited from a cross sectional population screening study of shoulder pain, conducted in the Greater Manchester area of the UK.
Of 92 subjects classified as having shoulder pain in the cross sectional study, 50 (54%) reported shoulder pain at followup about 3 years later. In 90% of cases this was accompanied by some disability specifically relating to the symptoms. Baseline factors that predicted symptoms at followup were: pain (indicated on a manikin) within a more narrowly defined shoulder region, shoulder pain related disability, pain on the day of examination, symptoms lasting more than one year, and a high score on the General Health Questionnaire, a measure of psychological distress.
Shoulder pain in the population is a longterm disabling symptom, although many subjects do not seek early medical consultation. Disability (independent of whether there was restriction of movement on examination) is a strong predictor of continuing symptoms. The outcome observed in epidemiological studies of shoulder pain will be influenced by the initial definition of symptoms.
确定人群中肩痛的自然病程，以及基于临床和个体因素的预后预测因素。此外，确定结局是否受所采用的肩痛定义的影响。
一项前瞻性队列研究，为期3年，研究对象来自于在英国大曼彻斯特地区进行的一项肩痛横断面人群筛查研究中招募的受试者。
在横断面研究中被归类为有肩痛的92名受试者中，约3年后随访时有50名（54%）报告仍有肩痛。在90%的病例中，这伴有一些与症状具体相关的功能障碍。预测随访时症状的基线因素有：在更狭义定义的肩部区域内疼痛（在人体模型上指出）、与肩痛相关的功能障碍、检查当天疼痛、症状持续超过一年，以及一般健康问卷得分高（心理困扰的一种测量方法）。
人群中的肩痛是一种长期导致功能障碍的症状，尽管许多受试者没有尽早寻求医疗咨询。功能障碍（与检查时是否存在活动受限无关）是持续症状的有力预测因素。肩痛流行病学研究中观察到的结局将受症状初始定义的影响。
