Asynchronous and Tailored Digital Rehabilitation of Chronic Shoulder Pain: A Prospective Longitudinal Cohort Study

Figures & data

Figure 1 Study flow diagram.

Table 1 Baseline Characteristics of Study Participants (N = 296)

Characteristic	Estimate
Age (years), mean (SD)	50.9 (11.6)
Age categories (years), N (%):
● <25	2 (0.7)
● 25–40	55 (18.6)
● 40–60	169 (57.1)
● > 60	70 (23.6)
Sex (females), N (%)	156 (52.7)
BMI, mean (SD)	28.7 (6.6)
BMI categories, N (%):
● Underweight (<18.5)	3 (1.0)
● Normal (18.5–25)	86 (29.1)
● Overweight (25–30)	105 (35.5)
● Obese (30–40)	85 (28.7)
● Obese grade III (>40)	16 (5.4)
Employment status, N (%):
● Employed (part-time or full-time)	275 (92.9)
● Unemployed (not working or seeking for opportunities)	21 (7.1)
Occupation type, N (%):
● White collar	184 (62.2)
● Blue collar	74 (25.0)
● Not applicable (eg retired, unemployed)	38 (12.8)
Exercise level (days per week), N (%):
● None	40 (18.9)
● 1–2 days	46 (21.7)
● 3–4 days	77 (36.3)
● > 5 days	49 (23.1)

Abbreviation: BMI, body mass index.

Table 2 Changes in Clinical Outcomes Between Baseline and 12 Weeks: Unconditional Intent-to-Treat Approach

Outcome, Mean (95% CI)	N	Baseline	End-of-Program	Mean Change	% Change
QuickDASH	296	26.07 (24.59; 27.55)	12.62 (11.08; 14.15)	13.45 (11.99; 14.92)	51.6%
Pain Level	296	4.56 (4.35; 4.77)	2.06 (1.81; 2.32)	2.50 (2.22; 2.77)	54.8%
Surgery Intent >0	161	24.38 (20.78; 27.98)	10.85 (6.27; 15.42)	13.53 (8.84; 18.23)	55.5%
Surgery Intent	296	13.27 (10.87; 15.68)	6.16 (3.60; 8.73)	7.11 (4.36; 9.86)	53.5%
GAD-7 ≥5	87	8.30 (7.56; 9.05)	4.12 (3.03; 5.22)	4.18 (3.00; 5.36)	50.3%
GAD-7	296	3.34 (2.89; 3.79)	1.87 (1.39; 2.35)	1.47 (0.95; 1.99)	43.9%
PHQ-9 ≥5	79	7.74 (7.11; 8.38)	2.82 (1.93; 3.71)	4.92 (3.86; 5.99)	63.6%
PHQ-9	296	3.13 (2.75; 3.51)	1.47 (1.12; 1.82)	1.66 (1.21; 2.11)	53.0%
FABQ-PA	296	11.70 (11.07; 12.32)	7.29 (6.48; 8.10)	4.41 (3.55; 5.27)	37.7%
WPAI Overall >0	141	25.27 (22.18; 28.35)	8.46 (4.61; 12.31)	16.81 (12.30; 21.31)	66.5%
WPAI Overall	251	13.97 (11.68; 16.27)	5.74 (3.47; 8.01)	8.24 (5.37; 11.11)	58.9%
WPAI Work >0	136	23.46 (20.62; 26.30)	7.53 (3.87; 11.18)	15.93 (11.51; 20.36)	67.9%
WPAI Work	251	12.44 (10.34; 14.54)	5.58 (3.32; 7.85)	6.86 (3.99; 9.72)	55.1%
WPAI Activity >0	236	29.01 (26.59; 31.44)	12.68 (9.45; 15.91)	16.33 (12.80; 19.86)	56.3%
WPAI Activity	296	23.03 (20.69; 25.37)	10.49 (7.87; 13.10)	12.54 (9.65; 15.43)	54.5%

Abbreviations: QuickDASH, Quick Disabilities of the Arm, Shoulder and Hand questionnaire; GAD-7, Generalized Anxiety Disorder 7-item scale; PHQ-9, Patient Health 9-item questionnaire; FABQ-PA, Fear-Avoidance Beliefs Questionnaire for physical activity; WPAI, Work Productivity and Activity Impairment questionnaire.

Figure 2 Longitudinal changes across time for all filtered variables. Primary outcome: QuickDASH; Secondary outcomes: (A) Pain level; (B) Surgery intent; (C) WPAI - overall; (D) GAD-7; (E) PHQ-9; (F) FABQ-PA. Cases filtered according to the following baseline thresholds – surgery intent scores > 0 points; GAD-7 scores ≥ 5 points; PHQ-9 scores ≥ 5 points; WPAI overall > 0 points.