The Effectiveness of Individual or Group Physiotherapy in the Management of Sub-Acromial Impingement: A Randomised Controlled Trial and Health Economic Analysis.

研究概要

One hundred and thirty-six patients with shoulder pain from shoulder impingement were randomized to receive 6 weeks of group physiotherapy or individual physiotherapy in this randomized equivalence trial. The primary outcome of interest was the change from baseline at 26 weeks in the Shoulder Pain and Disability Index (SPADI). Secondary outcomes of interest included active range of motion in external rotation and internal rotation, global patient self-assessment on a Visual Analog Scale (VAS), general health status with the Short Form 26 (SF-36) questionnaire, EuroQoL 5-Dimensions 5-level (EQ-5D-3L) questionnaire, and the Hospital Anxiety and Depression Scale (HADS). Outcomes were assessed at weeks 12, 26, and 52 post-treatment by a blinded researcher. The improvement from baseline in SPADI total scores at 26 weeks was significantly greater in the group physiotherapy group; however, the majority of patients did not provide the 26 week data as they were lost to follow-up. External rotation improvement from baseline at 26 weeks was significantly in favour of the individual physiotherapy arm (p=0.05), and improvement in EQ-5D-3L scores from baseline at 12 weeks was significantly in favour of the group physiotherapy arm. Otherwise, clinical outcomes were similar between groups. The cost of individual physiotherapy was 42 pounds per session compared to 17 pounds per session in the group physiotherapy arm. The overall cost of treatment was lower in the group physiotherapy arm.