Rotator cuff related pathology (RCRP), the most common source of shoulder pain, muscle weakness and functional limitations, can involve degeneration, tearing, or impingement of the rotator cuff muscles/tendons/bursa. Repetitive strain and poor biomechanics seen with workplace activities such as lifting and construction, are frequent causes of RCRP.
Evidence-based guidelines on effective prevention/management strategies for RCRP are unclear due to high heterogeneity in treatment approaches, patient populations and study methodologies used.
Taking into account the need to standardize care and optimize RTW, the Workers’ Compensation Board Alberta (WCB-AB) implemented an evidence-based shoulder clinical pathway in 2009 with the goals of identifying service delivery gaps that delay recovery.
The overall goal of this project is to understand the RTW, clinical
outcomes, and health services utilization of Albertan’ WCB claimants with RCRP who were treated with either usual care or an evidence-based clinical pathway. Determining whether an evidence-based shoulder clinical pathway provides better clinical outcomes than usual care to expedite recovery and RTW of workers with RCRP is needed.
Primary Objective: To compare RTW rates between claimants diagnosed with RCRP who were treated with an evidence-based shoulder clinical pathway (2014 to 2017) to those who were treated with usual care (2003-2008).
Secondary Objectives: To compare pain, function, and overall health and also health service utilization between claimants diagnosed with RCRP who were treated with an evidence-based shoulder clinical pathway (2014 to 2017) to those who were treated with usual care (2003-2008).
We anticipate that the evidence-based shoulder clinical pathway will lead to greater pain relief, functional improvement and overall health related quality of life than usual care. Improved outcomes and reduced health services will be reflected in less time returning to work.
Information gained from this study will inform WCB stakeholders (i.e. claimants, employers, administrative personnel) about the effectiveness of implementing a specific shoulder pathway. We will also determine what baseline factors determine better pain management, functional improvement and overall health for workers recovering from RCRP.