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Education and activation programme (EAP) ineffective on shoulder complaints
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SHOULDER & ELBOW
Education and activation programme (EAP) ineffective on shoulder complaints .

OrthoEvidence Journal (OE Journal) - ACE Report

OE Journal. 2013;1(11):223 BMC Musculoskelet Disord. 2007 Nov 15;8:112

111 patients with shoulder complaints (SCs) were randomized into one of two treatment groups. The first group was assigned to an education and activation program (EAP) in addition to usual care (UC) and the second group was only assigned to UC. Results indicated that the EAP did not have any significant effects on functional limitations and patient-perceived recovery in acute and sub-acute shoulder complaints when assessed at 6 and 26 weeks. A coincidental relationship between a catastrophising variable and functional limitations was discovered.


Dettagli sul finanziamento della pubblicazione +
Finanziamento:
Non-Industry funded
Sponsor:
The Netherlands Organization for Health Research and Development
Conflicts:
None disclosed

Rischio di pregiudizio

5/10

Criteri di segnalazione

16/20

Indice di fragilità

N/A

Was the allocation sequence adequately generated?

Was allocation adequately concealed?

Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?

Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?

Blinding Patients: Was knowledge of the allocated interventions adequately prevented?

Was loss to follow-up (missing outcome data) infrequent?

Are reports of the study free of suggestion of selective outcome reporting?

Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?

Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?

Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?

Sì = 1

Incerto = 0,5

Non rilevante = 0

No = 0

La valutazione dei criteri di segnalazione valuta la trasparenza con cui gli autori riportano le caratteristiche metodologiche e sperimentali dello studio all'interno della pubblicazione. La valutazione è suddivisa in cinque categorie che vengono presentate di seguito.

4/4

Randomization

1/4

Outcome Measurements

3/4

Inclusion / Exclusion

4/4

Therapy Description

4/4

Statistics

Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65

L'Indice di Fragilità è uno strumento che aiuta l'interpretazione dei risultati significativi, fornendo una misura della forza di un risultato. L'Indice di Fragilità rappresenta il numero di eventi consecutivi che devono essere aggiunti a un risultato dicotomico per rendere il risultato non più significativo. Un numero piccolo rappresenta un risultato più debole, mentre un numero grande rappresenta un risultato più forte.

Perché questo studio era necessario ora?

Some studies suggest that psychological and social factors play a role in the development and progression of chronic musculoskeletal diseases. The education and activation programme (EAP) was designed to help prevent the development of chronic shoulder complaints (SCs) and aims to do this by assisting patients in coping with psychosocial determinants which may lead to SCs.This study examines the effect of EAP on shoulder complaints.

Qual era la domanda di ricerca principale?

What is the effect of the education and activation programme (EAP) on functional limitations and patient-perceived recovery in patients with shoulder complaints at 6 and 26 weeks?

Caratteristiche dello studio +
Population:
111 Patients with shoulder complaints at rest or in motion for <3 months. (Age: >18)
Intervention:
Education and activation program (EAP) in addition to usual care (UC): The education portion of EAP involved providing patient-tailored education, while the activation portion involved assisting patients in the resumption or continuation of activities that were affected by SCs. The EAP included a minimum of 2 sessions for 20 minutes each for a maximum of 6 follow-up sessions over 6 weeks. (Mean age: 48.4) (n=56, 7 lost to follow up, M=36%)
Comparison:
Usual care (UC): UC was administered using the clinical guidelines of the Dutch College of General Practitioners. (Mean age: 49.9) (n=52, 15 lost to follow up)
Outcomes:
Patient-perceived recovery (PPR), Functional limitations (Assessed using the 16-item shoulder disability questionnaire (SDQ)), and other psychosocial variables measured at baseline (e.g. Catastrophising, coping, anxiety, depression, somatisation and distress)
Methods:
RCT
Time:
26 weeks (Follow-up at 6 and 26 weeks)
Quali erano i risultati importanti?
  • No statistically significant difference were found between the two groups when comparing baseline characteristics, except for catastrophisising (p=0.022).
  • The education and activation programme (EAP) did not demonstrate a significant effect on the outcomes of functional limitations (SDQ) or patient-perceived recovery (PPR) when a multilevel analysis was performed (p>0.05).
  • There was a statistically significant positive relationship between the catastrophising variable at baseline and functional limitations. This was a coincidental finding of this study.
Che cosa devo ricordare di più?

No significant effects were seen on the outcomes of shoulder complaints (SCs) at 6 and 26 weeks when patients were under the education and activation programme (EAP). A coincidental relationship between the measurement of "catastrophising" at baseline and functional limitations was discovered.

Come influenzerà l'assistenza ai miei pazienti?

Patients may not find any significant effects on shoulder complaints (SCs) when participating in the education and activation program (EAP) in addition to usual care (UC). Further studies are required to determine the effect of catastrophising on reducing functional limitations associated with shoulder complaints (SCs).

DISCLAIMER

Il contenuto di questa pagina è solo a scopo informativo e non intende sostituire la consulenza, la diagnosi o il trattamento medico professionale. Se ha bisogno di cure mediche, si rivolga sempre al suo medico o al pronto soccorso più vicino. Le opinioni, le convinzioni e i punti di vista espressi dalle persone sui contenuti presenti in questa pagina non riflettono le opinioni, le convinzioni e i punti di vista di OrthoEvidence.

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Come citare questo documento ACE Report

OrthoEvidence. Education and activation programme (EAP) ineffective on shoulder complaints. OE Journal. 2013;1(11):223. Available from: https://myorthoevidence.com/AceReport/Show/education-and-activation-programme-eap-ineffective-on-shoulder-complaints

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