Event 7: Evidence Review

Let’s review the level of evidence. For evidence-based practice, we have included a grading of evidence – strong, moderate, and weak.

We have given some guides as to how we rated the evidence for strong, moderate and week.

Evidence Levels

Strong Evidence

Meta-Analysis or Systematic Reviews, Randomized Clinical Trials

Moderate Evidence

Cohort Studies to help answer questions about prognosis, etiology or harm

Weak Evidence

Case Series, Case Reports, Case Control Study

Summary of Evidence

Let’s summarizes the evidence presented in this module.

For shoulder injections in adhesive capsulitis, there is strong evidence for use of shoulder injections in the treatment of adhesive capsulitis. In addition, there are references for a clinical practice guideline for adhesive capsulitis.

The Iowa Pain Thermometer Revised allows for a visual rating of pain severity and shows
moderate evidence.

Strong Evidence is present in the literature for the use of SBAR: Situation, Background, Assessment and Recommendation.

The PEG is a multidimensional pain impact tool and shows moderate evidence for use in older adults.

TENS has also shown moderate evidence for use in individuals with shoulder pain.

Take Home Messages

  • Adhesive capsulitis (frozen shoulder) is a common painful condition of the shoulder resulting from contraction of the glenohumeral joint capsule. In an older adult, nonsurgical treatments may include analgesics (e.g., acetaminophen, nonsteroidal antiinflammatory drugs), and intra-articular  corticosteroid injects. Home exercise regimens and physical therapy are often prescribed.
  • Many older adults prefer a visual representation of pain for rating pain severity or impact such as the Iowa Pain Thermometer or PEG.
  • The Beers Guide is a source for medication review for older adults.
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