A standardized criteria-based progressive shoulder exercise program is effective in managing rotator cuff-related shoulder pain: A prospective cohort study
Bibliographic record
Abstract
BACKGROUND: Non-operative management of patients with rotator cuff related shoulder pain (RCRSP) has been shown to be effective with outcomes similar to operative interventions. Exercise therapy and education are recommended as first-line treatments; however, program content, progression and referral criteria are typically inadequately detailed to be easily reproduced by clinicians. This study evaluated the effectiveness of a well-defined, criteria-based progressive exercise physical therapy (PT) program in patients with rotator cuff related shoulder pain (RCRSP) over a 26-week evaluation period. METHODS AND FINDINGS: A longitudinal, prospective cohort study evaluated 143 patients aged 30-65 years with RCRSP. Participants participated in a 12-week in-person and home-exercise shoulder program and were assessed at baseline, 6-weeks, 12-weeks and 26-weeks. Primary outcome measures were pain at rest, at night and with activity. Secondary measures were active range of motion (ROM), strength, and health related quality of life (HRQL) using the Western Ontario Rotator Cuff (WORC) score. RESULTS: Significant reductions in pain at rest, at night and with activity (p < 0.001) occurred within six weeks and continued to 26-weeks. Active range of motion (ROM), particularly abduction and external rotation in 90 degrees of abduction, significantly improved between 0- and 6-weeks (p < 0.001) as well as at 12-weeks (p < 0.001) and 26-weeks (p < 0.001). Strength similarly improved, especially between 6- and 12-weeks (p < 0.001). Ongoing improvements were reported at 26-weeks. Finally, the WORC score improved over time, with significant improvements at each measurement point, and clinically important improvements occurring within 12 weeks. CONCLUSION(S): Utilizing a criteria-based progressive PT program that provided detailed information, including progression criteria and a proven algorithm for referring non-responsive patients for an orthopedic surgical consult was effective in significantly reducing pain, improving active ROM, strength and HRQL in those living with RCRSP.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".