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;8:112111 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.
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)?
Sim = 1
Incerto = 0,5
Não relevante = 0
Não = 0
A Avaliação dos Critérios de Relato avalia a transparência com que os autores relatam as caraterísticas metodológicas e do ensaio na publicação. A avaliação está dividida em cinco categorias que são apresentadas de seguida.
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
O Índice de Fragilidade é uma ferramenta que auxilia na interpretação de achados significativos, fornecendo uma medida de força para um resultado. O Índice de Fragilidade representa o número de eventos consecutivos que precisam de ser adicionados a um resultado dicotómico para que o resultado deixe de ser significativo. Um número pequeno representa um resultado mais fraco e um número grande representa um resultado mais forte.
Porque é que este estudo era necessário agora?
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 a principal questão de investigação?
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?
- 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.
De que é que me devo lembrar mais?
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.
Como é que isto afectará o tratamento dos meus doentes?
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).
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