Table 2

Results for secondary outcomes at 6 weeks, 6 months and 12 months (intention to treat) based on linear mixed-effect model, adjusting for baseline scores, age, gender, duration of pain and location of clinic

Outcome measureTime pointInjection intervention groupExercise intervention group
US guidedUnguidedAdjusted* between group comparison
(reference: unguided)
Physiotherapist ledAdvice and exercise leafletAdjusted* between group comparison
(reference: leaflet)
Numerical measuresObserved mean (SD)Observed mean (SD)Mean difference (95% CI)P valueObserved mean (SD)Observed mean (SD)Mean difference (95% CI)P value
SPADI† pain subscale6 weeks47.6 (25.6)49.5 (26.0)−1.92 (−7.68 to 3.83)0.51345.6 (25.6)51.4 (25.7)−3.03 (−8.96 to 2.89)0.315
6 months47.0 (26.8)50.1 (28.0)−3.60 (−9.94 to 2.74)0.26642.9 (27.6)54.3 (26.1)−9.25 (−15.74 to −2.75)0.005
12 months40.8 (28.7)40.4 (27.7)−0.84 (−8.67 to 7.00)0.83436.5 (28.0)44.7 (27.9)−4.87 (−12.86 to 3.11)0.231
SPADI† disability subscale6 weeks35.6 (25.3)37.3 (24.2)−2.47 (−7.79 to 2.85)0.36335.7 (23.9)37.0 (25.4)−0.21 (−5.68 to 5.27)0.941
6 months37.3 (26.6)38.6 (26.4)−1.82 (−7.63 to 4.00)0.54033.8 (26.0)42.2 (26.2)−7.15 (−13.10 to −1.19)0.019
12 months33.4 (25.8)29.0 (25.2)3.09 (−3.93 to 10.12)0.38828.5 (25.6)33.7 (25.4)−2.98 (−10.13 to 4.18)0.415
Current shoulder pain severity1 week4.9 (2.2)5.0 (2.3)−0.15 (−0.73 to 0.44)0.6204.9 (2.3)5.0 (2.2)0.12 (−0.48 to 0.72)0.697
6 weeks3.6 (2.6)4.2 (2.7)−0.58 (−1.23 to 0.07)0.0833.4 (2.4)4.4 (2.8)−0.63 (−1.31 to 0.05)0.071
6 months3.9 (2.8)4.4 (3.1)−0.54 (−1.28 to 0.20)0.1553.7 (2.9)4.6 (2.8)−0.54 (−1.31 to 0.23)0.172
12 months3.3 (2.6)3.1 (2.8)−0.29 (−1.16 to 0.57)0.5062.6 (2.7)3.8 (2.6)−0.50 (−1.40 to 0.39)0.271
Pain self-efficacy‡6 weeks42.4 (15.1)39.2 (14.9)2.74 (−0.04 to 5.51)0.05341.5 (14.5)40.0 (15.6)1.10 (−1.75 to 3.95)0.451
6 months39.6 (15.7)40.5 (14.7)−0.83 (−4.44 to 2.78)0.65240.5 (15.5)39.6 (15.0)0.67 (−3.07 to 4.41)0.725
12 months43.0 (16.5)43.6 (15.6)2.10 (−2.66 to 6.88)0.38745.4 (16.5)41.2 (15.2)2.79 (−2.13 to 7.71)0.267
Fear of movement§6 weeks24.7 (6.7)25.2 (6.1)−1.01 (−2.37 to 0.35)0.14624.4 (6.9)25.5 (5.7)−0.72 (−2.11 to 0.67)0.310
6 months24.9 (7.1)25.2 (6.5)−0.73 (−2.42 to 0.95)0.39424.3 (7.0)25.7 (6.6)−1.13 (−2.85 to 0.60)0.201
12 months23.9 (7.3)24.0 (7.0)−1.20 (−3.36 to 0.96)0.27624.0 (7.5)23.9 (7.2)0.14 (−2.07 to 2.36)0.898
Illness perception
Consequences¶6 weeks4.3 (2.9)4.9 (3.0)−0.47 (−1.18 to 0.24)0.1974.3 (2.7)4.9 (3.1)−0.33 (−1.06 to 0.40)0.378
6 months4.4 (3.1)4.8 (3.2)−0.12 (−0.91 to 0.68)0.7724.1 (3.2)5.0 (3.1)−0.77 (−1.59 to 0.06)0.068
12 months3.6 (3.1)3.3 (3.1)0.13 (−0.79 to 1.05)0.7762.9 (3.0)4.0 (3.1)−0.97 (−1.92 to -0.02)0.045
Timeline**6 weeks5.7 (3.2)6.2 (3.2)−0.61 (−1.41 to 0.20) 0.1395.3 (3.0)6.6 (3.2)−1.19 (−2.01 to -0.36)0.005
6 months6.8 (3.3)7.0 (3.4)−0.25 (−1.20 to 0.70) 0.6096.2 (3.4)7.5 (3.2)−0.79 (−1.78 to 0.19)0.113
12 months5.8 (3.7)5.8 (3.8)0.01 (−1.16 to 1.19) 0.9815.4 (3.8)6.3 (3.7)−0.74 (−1.94 to 0.47)0.232
Personal control††6 weeks4.7 (3.0)4.3 (2.9)0.18 (−0.57 to 0.94)0.6374.3 (2.8)4.7 (3.1)−0.32 (−1.10 to 0.47)0.426
6 months4.6 (3.0)4.6 (3.2)−0.20 (−1.06 to 0.67)0.6524.8 (3.1)4.3 (3.1)0.39 (−0.51 to 1.29)0.396
12 months5.0 (3.1)5.4 (3.2)−0.25 (−1.29 to 0.79)0.6395.8 (3.1)4.5 (3.0)1.36 (0.29 to 2.43)0.013
Treatment control‡‡6 weeks6.5 (2.8)5.6 (3.2)0.76 (−0.01 to 1.52)0.0536.4 (2.8)5.7 (3.2)0.41 (−0.38 to 1.20)0.312
6 months6.0 (2.9)5.4 (3.5)0.41 (−0.51 to 1.32)0.3856.2 (2.9)5.3 (3.4)0.80 (−0.14 to 1.75)0.096
12 months6.0 (3.4)5.8 (3.5)0.59 (−0.55 to 1.74)0.3096.6 (3.2)5.2 (3.5)1.16 (0.18 to 2.14)0.020
Emotional representation§§6 weeks3.5 (3.4)4.8 (3.2)−0.93 (−1.58 to −0.28)0.0053.9 (3.3)4.4 (3.4)−0.50 (−1.17 to 0.18)0.148
6 months3.8 (3.4)4.2 (3.5)−0.16 (−0.97 to 0.66)0.7073.5 (3.4)4.4 (3.4)−0.87 (−1.70 to −0.03)0.043
12 months2.9 (3.1)3.1 (3.1)0.08 (−0.96 to 1.13)0.8752.6 (3.1)3.4 (3.1)−0.94 (−0.20 to 0.12)0.083
Short Form-12 (SF-12)
SF-12-PCS6 weeks40.7 (10.7)42.0 (10.1)−0.67 (−2.52 to 1.17)0.47641.4 (10.6)41.3 (10.3)0.62 (−1.30 to 2.54)0.526
6 months40.7 (11.2)41.9 (10.4)−1.13 (−3.55 to 1.29)0.36042.4 (10.5)40.2 (11.1)2.46 (−0.04 to 4.97)0.054
12 months41.7 (10.9)43.3 (12.2)−0.03 (−3.22 to 3.17)0.98843.4 (11.1)41.7 (12.1)1.62 (−1.66 to 4.91)0.333
SF-12-MCS6 weeks50.2 (11.1)48.3 (12.3)1.42 (−0.61 to 3.44)0.17149.9 (12.0)48.5 (11.6)1.62 (−0.47 to 3.71)0.128
6 months49.7 (11.9)48.1 (11.7)−0.23 (−2.88 to 2.42)0.86549.4 (12.0)48.4 (11.6)0.11 (−2.62 to 2.84)0.939
12 months49.2 (13.1)49.9 (10.9)−1.16 (−4.65 to 2.32)0.51349.3 (11.6)49.8 (12.4)−1.43 (−5.00 to 2.14)0.432
Work outcomes
Work performance6 weeks1.6 (2.8)2.0 (2.8)−0.40 (−1.11 to 0.28)0.2181.5 (2.5)2.1 (3.0)−0.60 (−1.38 to 0.03)0.063
6 months1.5 (2.6)2.0 (2.9)−0.50 (−1.16 to 0.31)0.2511.3 (2.5)2.2 (2.9)−0.90 (−1.58 to -0.19)0.016
12 months1.1 (2.2)1.5 (2.4)−0.40 (−1.01 to 0.21)0.2141.0 (2.1)1.5 (2.5)−0.50 (−1.18 to 0.13)0.105
Work presenteeism6 weeks7.5 (9.2)9.3 (9.7)−1.8 (−4.14 to 0.61)0.1467.0 (9.1)8.9 (9.6)−1.90 (−4.10 to 0.65)0.158
6 months6.9 (8.9)8.7 (9.5)−1.8 (−4.27 to 0.64)0.1416.8 (9.1)8.8 (9.3)−2.00 (−4.40 to 0.42)0.106
12 months6.1 (8.7)9.0 (9.6)−2.9 (−5.36 to −0.32)0.0296.9 (9.1)8.2 (9.4)−1.30 (−3.88 to 1.26)0.313
Time off work (days)6 weeks1.7 (7.8)1.2 (10.6)0.49 (−2.16 to 2.40)0.6870.8 (4.8)2.1 (12.2)−1.31 (−4.15 to 0.58)0.278
6 months1.1 (7.8)2.4 (20.2)−1.27 (−6.20 to 1.5)0.5341.1 (8.4)2.5 (19.9)−1.38 (−6.32 to 1.74)0.501
12 months1.0 (4.4)4.3 (21.7)−3.30 (−8.7 to 0.09)0.1363.3 (20.4)2.1 (9.5)1.24 (−2.31 to 6.33)0.577
Categorical measuresn (%)n (%)OR (95% CI)P valuen (%)n (%)OR (95% CI)P value
Global assessment of overall change
 Completely recovered or much better6 weeks39 (37.9)32 (29.9)1.79 (0.57 to 5.69)0.32140 (38.1)31 (29.5)1.46 (0.45 to 4.69)0.529
6 months35 (36.7)31 (34.1)1.05 (0.35 to 3.16)0.92638 (41.3)28 (29.5)1.66 (0.54 to 5.12)0.374
12 months36 (44.4)41 (49.4)0.72 (0.15 to 3.53)0.68546 (56.8)31 (37.4)3.47 (0.65 to 18.65)0.147
Shoulder pain at night
 Troubled most or every night6 weeks45 (43.3)56 (52.8)0.54 (0.23 to 1.25)0.15344 (41.9)57 (54.3)0.65 (0.27 to 1.52)0.315
6 months41 (43.2)46 (50.6)0.73 (0.31 to 1.76)0.48836 (39.6)51 (53.7)0.56 (0.23 to 1.37)0.204
12 months32 (39.5)25 (30.5)1.66 (0.61 to 4.53)0.32219 (23.8)38 (45.8)0.34 (0.12 to 0.95)0.039
  • *Adjusted for age, sex, current shoulder problem duration and clinic location.

  • †SPADI subscales, ranges from 0 to 100; 0=no pain/difficulty, 100=worst pain/so difficult it required help.

  • ‡Pain self-efficacy scale: 10 item scale, score range=0–60 (0=not at all confident, 60=completely confident).

  • §Tampa scale for kinesiophobia-11–score range from 11 to 44 with higher scores reflecting greater fear of movement or (re)injury.

  • ¶How much does your shoulder pain affect your life? rated on a 0–10 Numeric Rating Scale (NRS), 0=no affect at all, 10=severely affects my life.

  • **How long do you think your shoulder pain will continue? 0–10 NRS, 0=a very short time, 10=forever.

  • ††How much control do you feel you have over your shoulder problem? 0–10 NRS, 0=absolutely no control, 10=extreme amount of control.

  • ‡‡How much do you think your treatment can help your shoulder problem? 0–10 NRS, 0=not at all, 10=extremely helpful.

  • §§How much does your shoulder problem affect you emotionally? 0–10 NRS, 0=not at all affected emotionally, 10=extremely affected emotionally; 10SF-12-PCS; SF-12-MCS=SF-12 (scales are based on a ‘Normalised’ general population average of 50 with SD of 10).

  • MCS, Mental Component Scale; PCS, Physical Component Scale; SPADI, Shoulder Pain and Disability Index; US, ultrasound.