PHYSICAL EXAMINATION OUTCOMES AND SELF-EVALUATION OUTCOMES OF SHOULDER SURGERY: A COMPARISON BETWEEN WORKERS' COMPENSATION AND NON-WORKERS' COMPENSATION POPULATIONS. Claudia Angeli*; Christi Miller; Phoebe Powell Frazier Rehab Institute, Louisville, KY PURPOSE: This study compared functional measures and self evaluation scores in patients that had undergone shoulder surgery. The study was designed to compare outcome scores from sample populations of patients with private insurance and patients with workers compensation (WC) claims. BACKGROUNDS/SIGNIFICANCE: Previous studies have evaluated the relationship between various surgical outcomes and WC status. Most studies suggest that patients who are receiving WC do not respond to shoulder surgical treatments as well as patients not receiving WC. SUBJECTS: The WC group was comprised of 6 females (mean age 42.8) and 12 males (mean age 41.5). The Non-workers' compensation (NWC) group was comprised of 4 females (average age 43) and 13 males (average age 46.7). All subjects participating in this study were patients undergoing shoulder surgery performed by the same orthopaedic surgeon. METHODS AND MATERIALS: Subjects completed the Upper Limb-DASH prior to surgery and at 12 weeks post surgery. The Shoulder Assessment Form (American Shoulder and Elbow Surgeons) was completed prior to surgery, then at 3, 6 and 12 weeks post-op. This consisted of an objective section completed by the treating Physical Therapist and a self-evaluation section completed by the patient. All patients in this study received a typical physical therapy protocol for 9 weeks or more following surgery. ANALYSES: Non-parametric tests were performed in all the analyses. The Mann-Whitney U Test was used to compare the WC and NWC groups. The Wilcoxon test was used for repeated measures analysis. RESULTS: No significant differences were seen between groups in any pre-surgery measures. All physical assessment variables showed significant changes between the 3 weeks post-op and 12 weeks post-op evaluations for both groups. The only self-evaluation variables not showing significant changes between the two evaluation periods were: use of pain medication, in both groups, and feeling of shoulder instability, in the NWC group. Between group analysis at 3 weeks revealed significant differences in Abduction ROM (NWC 83.88; WC 69.89) p=0.05. At 12 weeks post-op, difference in pain during strength testing was significant (p=0.006) between the WC and NWC groups. At 3 weeks post-op, significant differences were seen with self-evaluation measures of pain in shoulder (p=0.03), use of pain medication (p=0.05),level of pain (p=0.02), feeling of shoulder instability (p=0.001), shoulder instability level (0.007). At 12 weeks, pain at night became significant (0.05); level of pain (0.001), feeling of shoulder instability (0.02) and level of instability (0.005) all showed significant differences. No between group differences were seen in the DASH scores. CONCLUSIONS: No differences were perceived in the physical assessment variables between the two groups; however, significant differences were obtained in self-evaluation variables with the WC group always performing worst than the NWC group. These results suggest that WC status needs to be controlled in clinical studies of shoulder surgery functional outcomes. FUNDING SOURCE: None. KEYWORDS: outcomes, shoulder, surgery, workers compensation Copyright 2009 by the American Physical Therapy Association. Requests for reprints should be directed to the corresponding author of the article. Educators, students, and other academic customers may receive permission to reprint copyrighted material from Physical Therapy (ISSN 1538-6724) by contacting the Copyright Clearance Center Inc, 222 Rosewood Dr, Danvers, MA 01923. Other types of customers who want permission to reprint should contact the APTA Editorial Office, Attn: Physical Therapy.