Table 4

 Trial outcomes

TrialOutcome
Ainsworth (2006)24Oxford Shoulder ScoreSF36
Outcome measured at 12 weeks after the start of the programme and compared to baseline measurementsMean improvement 10 pointsPain:
(range 3–16)Mean improvement 22 points
Mean at baseline: 34.2Role limitation due to physical health:
Mean at 3 months: 23.6Mean 10-point improvement
Role limitation due to emotional health:
Mean 23-point decline
General health:
Mean 9-point decline
Bokor et al (1993)25PainRange of movement:
Final evaluation (mean 7.6 years after onset, range 3.7–12 years)39 patients (74%) none or slight painMean elevation at initial consultation 121°
80 patients initially evaluated[2 patients at initial presentation]Mean elevation at follow up: 149°
53 included in final analysisLittle or no pain at follow-upMean external rotation range increased by 8°
34 patients reviewed by questionnaire and physical examination24/28 (86%) patients experiencing pain <3 monthsUCLA Shoulder Score:
19 patients by telephone interview only6/9 (67%) patients experiencing pain 3–6 months(34 patients assessed)
9/16 (51%) patients experiencing pain >6 monthsInitial mean score 14.6
Subjective weaknessFinal mean score 28.1
42/53 (79%) at initial consultation19 patients (56%) had a satisfactory result
experienced moderate or severe weakness.Greatest improvement in group treated within 3 months of onset. Least in group treated after 6 months of onset
18/53 (34%) at follow-up
Activities of daily living
At initial consultation 25% could perform ADL
with little or no compromise.
At final consultation 77%.
Goldberg et al (2001)26Simple Shoulder Test14/45 (30%) experienced worsening
Initial consultation 5.6 (SD = 3.2)5/47 (11%) remained unchanged
Final consultation 7.0 (SD =  3.8)Predicating outcome
Mean efficacy 1.4 (SD = 3.6)Dominance
Responsiveness to nonoperative treatmentPatients with symptoms in dominant shoulder were more likely to improve (p = 0.02)
determined to be low.Tucking shirt behind back
Only two factors of the SST had significantlyPatients who initially had difficulty performing this movement were more likely to improve (p = 0.04)
improved (p<0.01):
– ability to sleep on affected side
– ability to place hand behind head
SF36
Significant improvement (p = 0.01) in comfort score
Vitality, physical function, general health,
physical component summary decreased significantly.
27/46 (59%) experienced improvement
Hawkins and Dunlop (1995)27Constant–Murley ScoresOf the 6 components of the C-M Score (pain, function, positioning, strength, range of movement, total score) there were no significant differences between Groups 1 and 2 on the initial measurement. At follow-up there were no significant differences for pain, function, positioning, range of movement scores. There were significant differences in favour of Group 1 for strength (p = 0.008) and total score (p = 0.038)
21 patients continued with conservative treatment (Group 1)Group 1Patient satisfaction
12 “dissatisfied patients” eventually elected to have surgery (at a mean 13 months after commencing conservative programme, range 2 months–3.5 years); an additional 2 patients who elected not to have surgery were also dissatisfied with conservative treatment (group 2)Initial(using ASES)
14 good to excellent (75–100 points)Impairment measures (strength, muscle wasting, range of movement) did not correlate with patient satisfaction. Pain reduction, reduced analgesia, improved sleep, improved recreation, most strongly correlated with improved patient satisfaction
5 fair (50–74 points)Patients reporting loss of sleep and, to a lesser extent, compensation claim issues, at the initial assessment were predictors of an unsatisfactory outcome
0 poor (<50 points)
Final
18 good to excellent
1 fair
0 poor
Group 2
Initial
8 good to excellent
2 fair
4 poor
Final
8 good to excellent
2 fair
4 poor
Heers et al (2005)28Modified Constant–Murley ScoreRange of movement:
(maximum score 95 points)External rotation
Group I Mean increase 13.0 (SD = 7.9) p = 0.001Group I Mean increase 7.5° (SD = 8.7°) p<0.02
Group II Mean increase 13.2 (SD = 11.4) p-0.002Group II Mean increase 6.1° (SD = 7.8°) p<0.03
Group III Mean increase 17.5 (SD = 6.6) p = 0.005Group III Mean increase 10.0° (SD = 13.3°) p<0.05
Night painFlexion
[0 (no pain) – 15 (maximal pain)]Group I Mean increase 6.5° (SD = 14.9°) p<0.2
Group I (initial) 9.0 (SD = 3.5)Group II Mean increase 15.0° (SD = 26.2°) p<0.03
(12 weeks) 3.8 (SD = 2.6)Group III Mean increase 24.0° (SD = 38.1°) p<0.05
(p = 0.002)Abduction
Group II (initial) 8.6 (SD = 3.7)Group I Mean increase 22.5° (SD = 38.6°) p<0.03
(12 weeks) 3.9 (SD = 3.5)Group II Mean increase 26.4° (SD = 40.1°) p<0.03
(p = 0.003)Group III Mean increase 36.0° (SD = 38.1°) p<0.02
Group III (initial) 6.9 (SD = 6.9)Neer Sign and / or Hawkins and Kennedy Test
(12 weeks) 3.6 (SD = 4.8)Group I:
(p<0.03)Initially 12 positive (86%)
12 weeks 4 positive (29%)
Group II:
Initially 13 positive (93%)
12 weeks 7 positive (50%)
Group III:
Initially 9 positive (90%)
12 weeks 7 positive (70%)
Itoi and Tabata (1992)29Modified Wolfgang’s CriteriaOverall within the individual categories of the Modified Wolfgang’s Criteria, significant improvements in pain (p<0.001), range of movement (p<0.05) and function (p<0.001) were reported; no significant change was reported for strength
Pain (0–4)Follow-up scores significantly improved in all groups (p< 0.05) except for those who had experienced symptoms for more than 12 months
0 = severe, constant disablingIn addition, 32 patients (not available for clinical follow-up and contacted by telephone)
4 = absent regardless of activityExcellent (31.25%):
Motion [abduction] (0-4)10 patients
0 = <10°, 4 = >150°Good (56.25%):
Strength (0-4)18 patients
0 = absent, 4 = normalFair (6.25%)
Function (0–4)2 patients
0 = no functional value, 4 = no impairmentPoor (6.25%):
Total score2 patients
Poor outcome (0–7), fair (8–10), 11–14 (good), 15–16 (excellent)Of the 3 patients with FTT and traumatic dislocations, 2 were evaluated as good and 1 fair. No recurrence was reported
Overall final assessment:
Improved (72.6%), 38 patients (45 shoulders)
Unchanged (12.9%)
7 patients (8 shoulders)
Worse (14.5%)
9 patients (9 shoulders)
Overall:
Excellent (53%), 27 patients (33 shoulders)
Good (29%), 18 patients (18 shoulders)
Fair (16%), 8 patients (10 shoulders)
Poor (2%), 1 patient (1 shoulder)
Koubaa et al (2005)3018 patients (75%) had a C-M score higher than 80,VAS (pain at rest):
Evaluation before, at end and 6 months after end of last treatment.a VAS (pain) <20 mm, and a VAS (handicap) <20 mmInitial: 30.0 mm (SD = 21.6)
Treatment deemed successful if C-M score >80 achieved, a VAS (handicap) score of <20/100 mm and VAS (pain) <20/100 mm.at 6 months.End treatment: 6.3 mm (SD = 11.1)
At the end of treatment 19/24 (79.1%)6 months: 4.3 mm (SD = 6.0) (p = .001)
reported treatment to be effective or very effective.VAS (pain during movement):
At 6 months 18/24 (75%) reported treatmentInitial: 74.1 mm (SD = 19.5)
to be effective or very effective.End treatment: 21.1 mm (SD = 14.1)
Constant–Murley Score6 months: 17.1 mm (SD = 15.2) (p<0.0001)
Constant score improved from 44.7 (SD = 15.4)VAS (impairment):
to 71.8 (SD = 14.1) at the end of treatment andInitial: 56.4 mm (SD = 15.5)
to 74.7 (SD = 15.2) at 6 months (p<0.0001)End treatment: 14.7 mm (SD = 11.8)
6 months: 13.7 mm (SD = 15.4) (p<0.0001)
Palmer (1998)31Baseline versus (12 weeks) [change]Middle deltoid 7lbs (7lbs) [no change)
Flexion ROM 90° (160°) [+70°]External rotation 8lbs (17lbs) [+9lbs]
External rotation ROM Not measured (77°) [?]Internal rotation Not measured (20lbs) [?]
Internal rotation ROM Not measured (60°) [?]Triceps 10lbs (25lbs) [+15lbs]
Extension ROM 36° (51°) [+15°]At 2 years:
Strength (in lbs) Supraspinatus 0 (7lbs) [+7lbs]2 continuous lengths of a 40-foot indoor pool
Piccoli and Hasson (2004)32SPADIWashing hair
(range 0–100, 100 maximal disability)Initial 10/10, 7 weeks 3/10
At 7 weeks SPADI decreased 78%Range of active movement
(initial score 76, final score 17)Flexion
SF-12Initial 90°, 7 weeks 150°
Initially >2.5 standard deviation from the normAbduction
At 7 weeks within 1 standard deviation of the norm.Initial 80°, 7 weeks 139°
VAS (Pain)External rotation
Worse painInitial 45°, 7 weeks 89°
Initial 10/10, 7 weeks 3/10All patients’ goals achieved
Shoulder elevation pain(with minimal pain and difficulty)
Initial 8/10, 7 weeks 3/10Comb and wash hair, housework, gardening
Yamada et al (2000)33Group I-Exercise Group
Mean follow-up period 48 months (range 12 months–19 years)Mean JOAS increased from 53.2 to 71.1 (p = 0.002)
JOASPain decreased by 58%
Based on pain (30 points), function (20 points), range of movement (30 points), radiographic evaluation (5 points), joint stability (15 points). Maximum score 100 points.Function improved by 22%
ROM improved by 18%
8/13 (62%) satisfied
Group II-Surgery Group
(n = 26, 3 female, mean age 62 years (range 47–82)
Mean JOAS increased from 58.8 to 85.9 (p<0.0001)
Pain decreased by 71%
Function improved by 26%
ROM improved by 18%
22/26 (85%) satisfied