The Otago shoulder health study: A feasibility study to integrate formalised patient education with usual physiotherapy

Abstract

The overall study aim was to explore feasibility of a complex intervention that integrates formalised patient education with pragmatic, individualised physiotherapy for patients with rotator cuff-related shoulder pain (RCRSP). Specific aims were to determine: (a) participant recruitment and retention rates, (b) changes in patient-reported outcomes, (c) intervention fidelity, and (d) to scope intervention costs. Twenty-nine participants (M = 60.0 years, SD = 10.5) with RCRSP (duration ≥ 3 months) were recruited within 3 months. They attended up to eight physiotherapy sessions that included structured education about age-related shoulder pathoanatomy, pain biology and self-management, shoulder-specific exercise, general physical activity, and lifestyle considerations. The Shoulder Pain and Disability Index (SPADI) and other patient-reported outcomes measures (PROMs) were assessed at baseline, discharge, and 3-month follow-up. Completion rates for physiotherapy and PROMs were > 80%, confirming feasibility for retention. The mean decrease for the SPADI-Total from baseline to 3-month follow-up was 21.5/100, 95% CI [14.7, 28.2]. Self-efficacy, general health, and patients’ satisfaction with their condition improved from baseline to discharge and follow-up. Intervention fidelity was confirmed for integrating two of the four patient resources into treatment, but inconsistent for the remaining two resources and completion of participant diaries. The median number of treatments was 7.5, at a median cost of $600. More provider physiotherapist training is needed to enhance intervention fidelity in the research context.