Changes in pain and disability in patients with shoulder pain after three months of digitally delivered exercise and patient education.
Tobias Wörner, Paulina Sirard, Håkan Nero and 3 others
PMID 38835146WHAT IT FOUND
Patients with shoulder pain who completed three months of digital exercise and education reported significant reductions in pain and disability.
However, nearly half did not achieve a satisfactory symptom state, and outcomes were better in those with high adherence and shorter symptom duration.
Key findings
01Shoulder pain and disability scores improved significantly from baseline to three months, with large effect sizes for pain and medium for disability.
02Satisfactory adherence to the digital programme was a significant predictor of larger improvements in treatment outcomes.
03Patients with shoulder symptoms lasting more than 12 months showed less improvement in pain scores compared to those with shorter duration.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had no control group, so it cannot determine if the improvements were due to the treatment, natural history, or placebo effects. There was a high dropout rate; 1,167 of 1,986 registered patients did not complete the 3-month follow-up. The final sample only represents those who stuck with the programme, which may bias results toward those more motivated or less severely affected. The mean change in pain (-1.8 points) was below the defined minimal clinically important change of 2 points for the average patient, even though it was statistically significant. The sample was predominantly female and older (mean age 63.5 years), so results may not generalize to younger populations or those with acute traumatic shoulder pain.
Declared interests
The paper does not explicitly state funding sources or author conflicts of interest in the provided text, but notes the platform is part of the public healthcare system in Sweden.
The easy way to misread this
Do not assume the digital treatment caused the improvement. Without a control group, the observed reductions in pain and disability could be due to natural recovery over time or placebo effects. Additionally, the average pain reduction was less than the threshold for minimal clinically important change, so not all patients experienced a meaningful benefit.