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Current management and prognostic factors in physiotherapy practice for patients with shoulder pain: design of a prospective cohort study

Yasmaine H J M Karel1*, Wendy G M Scholten-Peeters12, Marloes Thoomes-de Graaf1, Edwin Duijn1, Ramon P G Ottenheijm3, Maaike P J van den Borne4, Bart W Koes2, Arianne P Verhagen12, On behalf of the ShoCoDiP (Shoulder Complaints and using Diagnostic ultrasound in Physiotherapy practice) study group, Geert-Jan Dinant3, Eric Tetteroo5, Annechien Beumer4, Joost B van Broekhoven6 and Marcel Heijmans7

Author affiliations

1 Faculty of Health, Research group Diagnostics, Avans University of Applied Sciences, PO Box 90.1164800, RA, Breda, The Netherlands

2 Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands

3 Department of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands

4 Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands

5 Department of Radiology, Amphia Hospital, Breda, The Netherlands

6 Fysiocollectief, Prinsenbeek, The Netherlands

7 Fysiomaatwerk, Heeswijk-Dinther, The Netherlands

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Citation and License

BMC Musculoskeletal Disorders 2013, 14:62  doi:10.1186/1471-2474-14-62

Published: 11 February 2013



Shoulder pain is disabling and has a considerable socio-economic impact. Over 50% of patients presenting in primary care still have symptoms after 6 months; moreover, prognostic factors such as pain intensity, age, disability level and duration of complaints are associated with poor outcome. Most shoulder complaints in this group are categorized as non-specific. Musculoskeletal ultrasound might be a useful imaging method to detect subgroups of patients with subacromial disorders.

This article describes the design of a prospective cohort study evaluating the influence of known prognostic and possible prognostic factors, such as findings from musculoskeletal ultrasound outcome and working alliance, on the recovery of shoulder pain. Also, to assess the usual physiotherapy care for shoulder pain and examine the inter-rater reliability of musculoskeletal ultrasound between radiologists and physiotherapists for patients with shoulder pain.


A prospective cohort study including an inter-rater reliability study. Patients presenting in primary care physiotherapy practice with shoulder pain are enrolled. At baseline validated questionnaires are used to measure patient characteristics, disease-specific characteristics and social factors. Physical examination is performed according to the expertise of the physiotherapists. Follow-up measurements will be performed 6, 12 and 26 weeks after inclusion. Primary outcome measure is perceived recovery, measured on a 7-point Likert scale. Logistic regression analysis will be used to evaluate the association between prognostic factors and recovery.


The ShoCoDiP (Shoulder Complaints and using Diagnostic ultrasound in Physiotherapy practice) cohort study will provide information on current management of patients with shoulder pain in primary care, provide data to develop a prediction model for shoulder pain in primary care and to evaluate whether musculoskeletal ultrasound can improve prognosis.