None listed
Conditions
Brief summary
There is a growing body of evidence of altered sensory processing in people with shoulder pain however it is not known which pain modulation pathway is affected in this population. It has also been reported that manual therapy techniques for the shoulder complex improve outcomes in patients with shoulder impingement compared to standard physiotherapy, sham or control interventions; however some findings suggest that a subgroup of individuals with shoulder pain may exist who will respond dramatically to these interventions. The aims of this study are to determine 1) the dominant pain modulation process in shoulder impingement individuals and 2) prognostic factors from the history, physical examination and pain modulation process in individuals with shoulder impingement who are likely to experience improvements following physiotherapy associated with manual therapy techniques. In this instance the population will be individuals with shoulder impingement symptoms and healthy controls. For the first aim of the study, all the subjects will be assessed twice at the baseline, with an interval of 48 hours between the measurements. For the second aim of the study, subjects with shoulder impingement will be treated during 4 weeks with manual therapy, physiotherapy and, when necessary, shoulder taping, and then reassessed after the 4-weeks rehabilitation program. The primary outcome measures will be heat pain threshold, cold pain threshold, cold pressor threshold, conditioned pain modulation and temporal summation of pain. The results of this study will contribute to our understanding of the dominant pain modulation process as mechanism for success in this technique and to guide physical therapists in selecting which patients with shoulder pain may experience improved outcomes following physiotherapy and manual therapy treatment. To date no scientific study has been conducted to investigate the pain modulation pathways in this population neither the predictive factors for successful outcomes concerning pain modulation in people with shoulder pain.
Interventions
Participants will receive a 30-minutes session per week for 4 weeks which includes mobilization-with-movement technique, taping for the shoulder and therapeutic exercises to improve scapular control, strengthen scapular stabilizers and rotator cuff muscles and stretch for the anterior and posterior shoulder and scapular elevator. Participants will be informed to perform the therapeutic exercises at home daily which will take around 30 minutes. A physiotherapist with more than 4 years of practic
Participants will receive a 30-minutes session per week for 4 weeks which includes mobilization-with-movement technique, taping for the shoulder and therapeutic exercises to improve scapular control, strengthen scapular stabilizers and rotator cuff muscles and stretch for the anterior and posterior shoulder and scapular elevator. Participants will be informed to perform the therapeutic exercises at home daily which will take around 30 minutes. A physiotherapist with more than 4 years of practice will administer the manual therapy and physiotherapy at the clinic as well as improve the exercises weekly at each appointment. A shoulder diary will be used to monitor adherence to the exercises performed at home and also to monitor pain scores during the 28-days protocol.
Sponsors
Griffith University
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Shoulder pain in the anterosuperior aspect of the shoulder for longer than 6 weeks, and classified with shoulder impingement with at least 3 of the following findings: positive Neer impingement test, positive Hawkins-Kennedy test, positive Jobe test, pain with passive or isometric resisted shoulder lateral rotation, pain with active shoulder elevation, pain with palpation of rotator cuff tendons, and pain in the C5 or C6 dermatome region. Healthy subjects: no history of shoulder or neck pain or injury; no history of any kind of chronic pain.
Exclusion criteria
History of cancer, previous fractures of the shoulder complex, recent shoulder surgery, corticosteroid injection into the glenohumeral joint within the previous 6 months, any neurological or auto-immune disorder, any recent shoulder dislocation, or if the shoulder pain was considered to be cervical in origin, history of fainting, dizziness, lightheadedness, chest pain or shortness of breath, or any history of cardiac disease.
Outcome results
None listed