• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Chronic Disease

A physiotherapist-guided session with corticosteroid injection is cost-effective for rotator cuff injuries

byNeel MistryandTeddy Guo
August 11, 2021
in Chronic Disease, Orthopedic Surgery
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. There were no significant differences in shoulder pain and disability indices between progressive exercise vs. best practice physiotherapy and corticosteroid injection vs. no injection.

2. Best practice advice (single physiotherapy session) plus corticosteroid injection was found to be the most cost-effective intervention at approximately £479 per quality-adjusted life years gained.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Rotator cuff injuries are commonly managed through a combination of pharmacologic and non-pharmacologic therapies. While physiotherapist-prescribed exercise is helpful, corticosteroid injections are also useful for managing inflammation and pain relief. However, there exists little evidence around the effectiveness of said treatments. Additionally, physiotherapy can be time-consuming, and it is uncertain whether having additional expert-guided sessions has a favorable cost-benefit relationship. This randomized controlled trial aimed to compare the clinical effectiveness and cost-effectiveness of individual-based exercise programme with a single physiotherapy session, with or without corticosteroid injection, in patients with rotator cuff injury. The primary outcome was the Shoulder Pain and Disability Index (SPADI) score at 12 months, measured on a scale of 0-10, while key secondary outcomes included pain and function sub scores, serious adverse events, and work absence. According to study results, scores for progressive exercise and best practice advice were similar over 12 months, as were scores for corticosteroid injection and no injection. This is the largest study, to date, to assess the effect of exercise interventions in patients with new-onset shoulder injury.

Click to read the study in The Lancet

Relevant Reading: Steroid Injection Versus Physiotherapy for Patients With Adhesive Capsulitis of the Shoulder

In-depth [randomized controlled trial]: Between March 10, 2017, and May 2, 2019, 2287 patients were screened for eligibility from 20 National Health Service trusts in the UK. Included patients were ≥18 years of age with recent onset rotator cuff injury. Those with a history of shoulder trauma, neurological disease affecting the shoulder, and corticosteroid injection or physiotherapy within past 6 months were excluded. Altogether, 708 patients were enrolled and randomly assigned to one of four groups (n=174 to progressive exercise, n=174 to best practice advice, n=182 to corticosteroid injection plus progressive exercise, and n=178 to corticosteroid injection plus best practice advice). Briefly, those assigned to progressive exercise received up to six sessions with a physiotherapist where exercises and progression schemes were individualized to the patient. Conversely, those assigned to best practice advice received one session with a physiotherapist and progression through exercises was self-guided by the patient’s capability.

RELATED REPORTS

High intensity interval training improves fitness in children and adolescents

High intensity multimodal training improved aerobic fitness and exercise enjoyment

Blended physical literacy interventions may improve physical literacy in children

The mean age of patients was 55.5 years (standard deviation [SD] 13.1) and majority of them (51%) were male. On average, patients experienced symptoms for 4 months (interquartile range [IQR] 3-6) and had a SPADI score of 54.1 (SD 18.5) at baseline. After 12 months, patients in all four groups showed improvements in their SPADI score from baseline. However, throughout 12 months, there were no significant differences in SPADI scores between progressive exercise and best practice advice (adjusted mean difference -0.66, 99% confidence interval [CI] -4.52 to 3.20) as well as between corticosteroid injection and no injection (adjusted mean difference -1.11, 99% CI -4.47 to 2.26). This was also the case for most secondary outcomes. There were slight differences in patient-reported global impression of treatment for progressive exercise over 6 and 12 months, and improvement in shoulder pain and function at 8 weeks with corticosteroid injection. Cost-benefit analyses looking at the cost per quality-adjusted life-years (QALYs) gained found that best practice advice with corticosteroid injection was the most cost-effective intervention at £479 per QALY gained.

Image: PD

©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: corticosteroidCorticosteroid injectionexercisemethylprednisoneRotator Cuff Injuryshoulder impingementShoulder Pain and Disability Index (SPADI)Shoulder Sprain
Previous Post

#VisualAbstract: Prevalence of toxigenic and non-toxigenic asymptomatic Clostridioides difficile colonization in pediatric populations

Next Post

Adolescent depression and suicide risk increased during the COVID-19 pandemic

RelatedReports

Adolescent mothers in protective care more likely to have their children placed in care
Pediatrics

High intensity interval training improves fitness in children and adolescents

June 15, 2022
Use of legal performance enhancing substances increases risk of future anabolic steroid use
Wellness

High intensity multimodal training improved aerobic fitness and exercise enjoyment

June 14, 2022
Multiple variables related to physical activity levels in preschool children
Pediatrics

Blended physical literacy interventions may improve physical literacy in children

June 13, 2022
Exercise improves aromatase inhibitor-induced arthralgia in breast cancer survivors
Wellness

Wellness Check: Exercise

June 9, 2022
Next Post
Children’s hospital visits for suicide ideation and attempts are increasing

Adolescent depression and suicide risk increased during the COVID-19 pandemic

Cervical cancer screening practices less cost-effective than suggested guidelines

HPV Testing for Women Aged 60-64 Detected More High-Grade Lesions than Cytology for Cervical Cancer Screening

#VisualAbstract: Prevalence of toxigenic and non-toxigenic asymptomatic Clostridioides difficile colonization in pediatric populations

#VisualAbstract: Magnetic resonance imaging-targeted biopsy noninferior to standard biopsy for prostate cancer screening

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Stereotactic body radiotherapy as a state of the art treatment option in inoperable non-small cell lung cancer [Classics Series]
  • Health system-based care associated with better treatment use and high rates of tobacco abstinence at 3 months post-discharge in hospitalized smokers
  • APOEε4 genotype may increase risk of chronic traumatic encephalopathy following repetitive head impact
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.