Long-term shoulder-related secondary health-care contact among people with subacromial pain: a secondary analysis of a randomized controlled trial of home-based vs. supervised exercise regimens
In brief
Home-based exercise shows no increase in 5-year shoulder doctor visits or surgery compared with supervised rehab
In a 5-year follow-up of 208 patients with subacromial pain, 31% of those doing home-based exercises and 33% of those receiving supervised therapy had shoulder-related health-care contacts, and surgery rates were 20% versus 18% respectively. The odds of additional visits or operations were essentially unchanged, suggesting home programs can be a scalable option, though larger trials are needed for definitive conclusions.
- Journal
- JSES international (Q1)
- Published
- 12 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Nina Dyrberg Lorenzen, Cecilie Ruud Budtz, David Høyrup Christiansen
- PMID
- 42761901
- DOI
- 10.1016/j.jseint.2026.101779
Why clinicians should know about it
- Picked for Surgery (top studies of the week, 20 September 2026): Ranked by evidence level and journal quartile
Abstract
BACKGROUND: Subacromial pain is associated with substantial individual burden and health-care costs. Exercise rehabilitation can be delivered either at home or under physiotherapist supervision. This study investigated whether home-based exercise rehabilitation was associated with increased long-term secondary health-care utilization compared with supervised exercise rehabilitation. METHODS: A total of 208 participants were randomized to home-based, group-based, or individually supervised exercise rehabilitation. For this secondary analysis, the 2 supervised groups were pooled and compared with the home-based group. The outcomes were shoulder-related secondary health-care contacts and shoulder surgery during the 5-year follow-up. Associations were analyzed using logistic regression and reported as adjusted odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: During the 5-year follow-up, 22/71 participants (31%) in the home-based group and 45/137 (33%) in the supervised group had a shoulder-related secondary health-care contact (adjusted OR 0.91; 95% CI 0.52-1.61). Shoulder surgery was recorded in 14/71 participants (20%) in the home-based group and 24/137 (18%) in the supervised group (adjusted OR 1.16; 95% CI 0.42-3.22). CONCLUSION: In this 5-year register-based follow-up of a randomized controlled trial, we found no evidence of increased shoulder-related secondary health-care contacts or surgery following home-based compared with supervised exercise rehabilitation for subacromial pain. However, the estimates were imprecise and should be interpreted with caution. These findings support home-based exercise as a potentially scalable rehabilitation strategy, although larger studies are needed to confirm long-term health-care utilization outcomes.
Abstract as published, via PubMed.
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