Margit Kooijman

Prognostic factors | 81 Table 5 gives an overview of prognostic factors studied at least twice that have shown no association with out- come. It shows that there is strong evidence that range of motion, age, psychological factors, education, comorbidity, muscle strength, dominance and medication use do not predict outcome in primary care populations. Body Mass Index appears not to be associated with out- come in occupational populations and gender, age, previous physiotherapy, GP treatment, psychological factors and, to a lesser extent, range of motion show no relationship with outcome in secondary care populations. TABLE 5. Overall level of evidence for prognostic factors with no association with outcome Discussion A few conclusions can be drawn from this update of the literature on prognostic factors on shoulder disorders. In primary care populations, higher shoulder pain intensity, concomitant neck pain and a longer duration of symptoms seem to show an association with a poorer outcome whilst range of motion, age, psychological factors, education, comorbidity, muscle strength, arm dominance and medication use do not seem to be associated with outcome. In occupational populations it is less evident which prognostic factors are associated with outcome. Greater disability and the existence of previous shoulder pain show an association with a poorer outcome in secondary care population. Prognostic factor assessed at baseline Outcome QS > 60 % QS ≤ 60 % Levelofevidence Primary care Restricted range of motion 14,15,22,23 Poorer No association ─ 3/3 1/1 ─ Strong Younger age 5,14,15,18,22 Better 1/5 ─ Strong No association 4/5 ─ Comorbid psychological factors 5,14,15,22,35 No association 5/5 ─ Strong Education 15,35 No association 2/2 ─ Strong Comorbidity 11,27 No association 2/2 ─ Strong Muscle strength 14,35 No association 2/2 ─ Strong Dominance 5,15,18 No association 3/3 ─ Strong Medication use 14,18 No association 2/2 ─ Strong Secondary care Gender 11,17,24-26,28,36 No association 2/2 5/5 Strong Older age 11,17,24-28,36 Poorer ─ 1/6 Strong No association 2/2 5/6 Previous physiotherapy 11,17 No association 2/2 ─ Strong GP treatment (medication) 11,17 No association 2/2 ─ Strong Psychological factors 11,17 No association 2/2 ─ Strong ROM 11,24 No association 1/1 1/1 Moderate Occupational setting BMI 12,13,16,32 No association 1/1 3/3 Strong