Background & Aims

Shoulder pain is common in the general population. Satisfaction with shoulder function and perception of the shoulder as normal may be influenced by the pain severity and shoulder impairment. Moreover, pain literature supports that physical exercise participation is an effective intervention for individuals with shoulder pain. Participating in exercise may positively affect satisfaction with shoulder function and perception of the shoulder as normal. This study aims to understand the association between satisfaction with shoulder function, perception of the symptomatic shoulder as a percentage of normal, pain intensity, functional impairments, and frequency of exercise participation.

Methods

We recruited individuals with non-operative shoulder pain seeking physical therapy care during their initial evaluation. The Penn Shoulder Score (PSS) was used to address pain (at rest, daily, and performing strenuous activities), shoulder function satisfaction, and shoulder functional impairments. The Single Assessment Numeric Evaluation (SANE) was used to evaluate the perception of the symptomatic shoulder as a percentage of normal. Participants were asked about the frequency of exercise participation (no, once per week, twice per week, three times per week, or more than three times per week) All questionnaires were answered through REDCap. The Shapiro-Wilk test was used to verify data normality. Pearson and Spearman tests were used to identify the relationship between the variables. The relationship was considered statistically significant when p <0.05.

Results

Thirty-nine participants (20 male, 61.6 ± 16.9 years of age) were included. Higher satisfaction with shoulder function was moderately correlated with lower daily pain (r= -0.45; p<0.01), lower pain performing strenuous activities (r= -0.47; p<0.01), and lesser functional impairments (r = 0.56; p < 0.01). Perceiving the shoulder as normal is related to lower daily pain (r= -0.38; p=0.02), lower pain performing strenuous activities (r= -0.48; p<0.01), and lesser functional impairments (r= 0.67; p<0.01). Higher frequency of exercise participation was moderately correlated with lower daily pain (r= -0.37; p=0.02), lower pain performing strenuous activities (r= -0.42; p<0.01), and better functional impairments (r= 0.35; p=0.02), but it did not correlate with satisfaction of shoulder function nor perception of the shoulder as normal. Pain at rest was not correlated with any outcome. Pain/impairments and shoulder performance seem to be the main complaints of the participants.

Conclusions

Patients with higher satisfaction with shoulder function and better perception of the shoulder as normal were presented with lower pain intensity (daily pain and during activities) and lesser shoulder functional impairments. On the other hand, pain at rest seems not to be associated with satisfaction and perception of the shoulder as functional and normal. Furthermore, a higher frequency of exercise participation throughout the week seems to be associated with daily pain and pain during activities, but not with satisfaction with shoulder function nor perception of the shoulder as normal, suggesting the participants seek physical therapy treatment due to shoulder pain/impairments and dissatisfaction with the shoulder performing exercise.

References

Luime JJ, Koes BW, Hendriksen IJM, Burdorf A, Verhagen AP, Miedema HS, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Vol. 33, Scandinavian Journal of Rheumatology. 2004. p. 73–81.

Sluka KA, O’Donnell JM, Danielson J, Rasmussen LA. Regular physical activity prevents development of chronic pain and activation of central neurons. J Appl Physiol (1985). 2013 Mar 15;114(6):725-33. doi: 10.1152/japplphysiol.01317.2012.

Lesnak JB, Sluka KA. Mechanism of exercise-induced analgesia: what we can learn from physically active animals. Pain Rep. 2020 Sep 23;5(5):e850. doi: 10.1097/PR9.0000000000000850.

Cools AM, Maenhout AG, Vanderstukken F, Declève P, Johansson FR, Borms D. The challenge of the sporting shoulder: From injury prevention through sport-specific rehabilitation toward return to play. Ann Phys Rehabil Med. 2021 Jul;64(4):101384. doi: 10.1016/j.rehab.2020.03.009.

Presenting Author

Lucas Araújo Almeida

Poster Authors

Lucas Araújo de Almeida

Doctor

Department of Physical Therapy. University of Florida

Lead Author

Giorgio Zeppieri Jr

University of Florida

Lead Author

Joel Bialosky

University of Florida Health Rehabilitation

Lead Author

Federico Pozzi

University of Florida

Lead Author

Topics

  • Assessment and Diagnosis