Use of a surgical referral algorithm within a standardized shoulder physical therapy program to assist clinical decision-making
Notice bibliographique
Résumé
Determine (a) utility of a shoulder referral algorithm, (b) patients improving ≥15% on the Western Ontario Rotator Cuff(WORC) score with standardized Physical Therapy(PT) +home exercises, and (c) presenting characteristics among PT-Only, PT + Surgical Consult and Surgery participants. Prospective cohort study of patients 30–65 years old with shoulder pain. A standardized PT program assessed pain, ROM, strength and exercise tolerance (i.e., referral algorithm) at 2-, 6- and 12-weeks to determine if a surgical consultation might be beneficial. A blinded research assessor evaluated pain, ROM, strength and WORC score at 6-, 12-weeks and 6-months. The proportion improving WORC scores ≥15% and group differences were also evaluated. 32/128 (25%) participants underwent consultation with 16 (12.5%) undergoing surgery. WORC scores improved ≥15% by 12-weeks in most PT-Only/PT + Surgical Consult participants (<i>n</i> = 77[70%]) and was maintained at 6-months. Surgery participants used more NSAIDs (<i>p</i> = 0.01), injections (<i>p</i> = 0.002) and trended to higher opioid use (<i>p</i> = 0.06). PT + Surgical Consult/Surgery participants (<i>n</i> = 16/32; 50%) knew diagnostic imaging results more than PT-Only (<i>n</i> = 26; 31%) (<i>p</i> = 0.02). Surgery participants presented with worse pain, ROM, strength and WORC scores than PT-Only (<i>p</i> < 0.05). The algorithm identified those with worse symptomology (25%), 50% of whom underwent surgery. WORC scores improved ≥15% in most participants (70%). Presenting characteristics were significantly worse between PT-Only and Surgery participants. Patients presenting with rotator-cuff related shoulder pain are likely to report reduced pain, and improved range of motion, strength and health-related quality of life within 3-months of starting a physical therapy program that includes home exercises.A surgical referral algorithm based on patient symptomology and response to treatment may assist physical therapists in determining when patients with shoulder pain might benefit from a surgical consult, often in advance of 3-months.Patients who required surgery tended to present with more pain, loss of range of motion and strength than those who received physical therapy only, as well as a history of more injections and non-steroidal anti-inflammatory drug use. Patients presenting with rotator-cuff related shoulder pain are likely to report reduced pain, and improved range of motion, strength and health-related quality of life within 3-months of starting a physical therapy program that includes home exercises. A surgical referral algorithm based on patient symptomology and response to treatment may assist physical therapists in determining when patients with shoulder pain might benefit from a surgical consult, often in advance of 3-months. Patients who required surgery tended to present with more pain, loss of range of motion and strength than those who received physical therapy only, as well as a history of more injections and non-steroidal anti-inflammatory drug use.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,039 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».