Objective: To investigate the effect on shoulder pain and disability of teaching patients with shoulder pain how to undertake a home-based exercise program. Design: A randomized controlled trial conducted from September 2015 to January 2016. Setting: Participants’ home. Participants: Sixty participants with shoulder pain who were waiting for physiotherapeutic treatment. Interventions: The control group ( n = 30) received minimal education about their shoulder condition and instructions to continue their activities as normal. The intervention group ( n = 30) received a two-month home exercise program with one-hour sessions delivered by a physiotherapist to begin and one month after the program for exercise instructions. Main measures: The primary outcome was change in the Shoulder Pain and Disability Index (SPADI). The secondary outcomes included change in the numeric pain rating scale and medication intake for pain relief. Results: The patients’ average age was 54.3 (13.8) years. SPADI scores at baseline were 60.9 (16.5) in the intervention and 64.7 (15.3) in the control group. After two months, the SPADI scores decreased to 18.8 (28.6) and to 61.4 (24.0), respectively, in the intervention and control groups with an estimated mean difference of 40.0, effect size: 1.61. The intervention group showed a reduced pain intensity (estimated mean difference: 3.7, effect size: 2.43) and medication intake (chi-square: 0.001). The number needed to treat was 1.2 for one patient to have a SPADI score <20. Conclusion: Teaching patients with shoulder pain how to undertake a home-based exercise program improved shoulder function and reduced pain intensity and medication intake over two months.

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También se observó que los resultados de las evaluaciones no dependen de la postura empleada.

Objectives This study aimed to investigate self‐efficacy levels of patients after finishing rehabilitation for chronic musculoskeletal conditions and identify factors related to self‐efficacy. Method Two hundred and eight patients aged >40 years with musculoskeletal disorders were included. Self‐efficacy was assessed by the Chronic Pain Self‐Efficacy Scale (CPSS), and regression analyses were used to test six predictors of self‐efficacy: age, symptom duration, number of physical therapy sessions, postdischarge pain intensity, perceived clinical improvement, and cognitive reassurance. Self‐efficacy was compared between patients who reported improvement and worsening of their clinical condition, and a cutoff value for self‐efficacy was established using receiver operating characteristic curve analyses to distinguish patients with severe pain from those with mild to moderate pain. Results Better perceived clinical improvement (Beta = −0.37, p = 0.000), lower pain intensity (Beta = −0.33, p = 0.000), and a lower number of physical therapy sessions (Beta = −0.12, p = 0.027) were related to greater self‐efficacy. No significant associations were observed between self‐efficacy and age, symptom duration, and cognitive reassurance. The patients who reported improvement had greater self‐efficacy (204.76 ± 52.80) than those who reported worsening of their clinical condition (145.45 ± 44.18; p = 0.000). A CPSS score of 172 points (sensitivity of 0.77; specificity of 0.72) may indicate low self‐efficacy. Conclusion A higher perception of self‐efficacy after discharge from physiotherapy is associated with better perceived clinical improvement, lower pain intensity, and a lower number of physical therapy sessions. Therefore, interventions to support patients' exercise‐based rehabilitation should include self‐efficacy, which may affect the prognosis of patients with chronic conditions.

BACKGROUND AND OBJECTIVES: Patellofemoral pain syndrome (PFPS) is one of the commonest disorders affecting knee joint. This study aimed at evaluating symptoms and functional limitations of PFPS patients. METHOD: Participated in this study 26 PFPS patients (PFPSG) and 31 clinically healthy patients (CG), paired by age, height and body mass. Evaluation cards and Kujala questionnaire were applied. Then patients went through two functional tests: crouching, climbing and descending a step for 30 seconds, in addition to being oriented to walk 8 m in a leveled surface, to climb and descend a stair and a ramp, and such activities were randomly performed. Pain intensity was evaluated through the visual analog scale (VAS) before and after each activity. Wilcoxon and U Mann-Whitney tests were used for statistical analysis, considering significant p = 0.05. RESULTS: The PFPS group had lower scores (75.8 ± 11.8) in Kujala questionnaire, as compared to the C group (100 ± 0.0) (p = 0.001). From 26 PFPS patients,