Biomedical subjects

Carol A Kennedy

Publications and source records attributed to Carol A Kennedy.

3 recordsLinked to original sources

PubMed2006

Eight predictive factors associated with response patterns during physiotherapy for soft tissue shoulder disorders were identified.

BACKGROUND AND OBJECTIVE: Combining information on initial and final state with information on speed of response may reflect the clinical reality of the course of recovery from soft tissue shoulder disorders. The purpose was to identify baseline factors that predict patterns of response to physiotherapy. STUDY DESIGN AND SETTING: Prospective cohort of consecutive clients (n=361) with soft tissue shoulder disorders attending physiotherapy. A previous study identified four typical patterns of response such that each individual was assigned to one of four clusters (dependent outcome). Independent predictors (n=28) included demographics, disorder-related and disability measures, treatment factors, clinical findings, and expectations for recovery. Multivariable multinomial logistic regression techniques were used. RESULTS: Predictors differentiating patterns of response were: Age (by decade), duration of current shoulder problem, worker's compensation claim, client's global rating of problem, Physical Component Score (SF-36), Mental Component Score (SF-36), over the counter medication use, and therapist prediction of client to return to usual activity. CONCLUSION: Using a clinically sensible outcome, we have identified several predictors that can be used by clinicians in clinical decision making.

Adolescent↗

PubMed2006

Prognosis in soft tissue disorders of the shoulder: predicting both change in disability and level of disability after treatment.

BACKGROUND AND PURPOSE: Clinicians often are faced with questions about prognosis and outcome of shoulder disorders. The purpose of this study was to identify predictors of both change in disability and level of disability following physical therapy treatment. SUBJECTS: The subjects were consecutive patients (n=361) who were receiving physical therapy for soft tissue shoulder disorders. METHODS: Clinical response to physical therapy, which was measured using the Disabilities of the Arm, Shoulder, and Hand (DASH) measure, was assessed over 12 weeks. The 28 independent baseline predictors included demographics, disorder-related and disability measures, medication use, clinical findings, and expectations for recovery. Multiple linear regression techniques were used. RESULTS: Predictors of greater disability at discharge were: higher initial disability, therapist prediction of restricted activities at discharge, workers' compensation claim, older age, and being female. Predictors of greater improvement in disability were: shoulder surgery, higher pain intensity, shorter duration of symptoms, younger age, and poorer general physical health (measured using the 36-Item Short-Form Health Survey [SF-36]). DISCUSSION AND CONCLUSIONS: Prognostic factors differ depending on the format of the outcome. Only age was significant in both models.

Adolescent↗

PubMed2005

Beyond return to work: testing a measure of at-work disability in workers with musculoskeletal pain.

BACKGROUND: There are a limited number of validated measures of a patient's perception of the level of difficulty that they are having at their job. The purpose of this study was to evaluate the psychometric properties of the 16-item Work Limitations Questionnaire (WLQ-16). METHODS: A sample of 42 workers reporting to a workplace occupational health unit with upper limb or low back pain were enrolled in an observational study. Participants were assessed at baseline, 4 and 12 weeks post reporting. Psychometric testing (distributions, Cronbach's alpha, construct validity and responsiveness to change in problem and pain) was done using the baseline and 12-week data. RESULTS: The WLQ-16 had evidence of internal consistency, construct validity and responsiveness. Some ceiling effect was found in the domains of mental-interpersonal and output demands. Physical demands suffered from missing values in 18/42 due to not-applicable content. Construct validity revealed that there was less discrimination at the higher (less limited) end of the scale. Responsiveness was present, though less than found with other measures of function and pain. CONCLUSIONS: The WLQ-16 shows promise as a measure of at-work disability. Further testing to evaluate the ceiling effect and responsiveness to constructs of change more closely related to work disability is recommended.

Adult↗