None listed
Conditions
Brief summary
This is a two-arm, assessor-blinded, patient-blinded, randomized controlled feasibility trial. Twenty-four patients with shoulder subacromial pain will be recruited randomly allocated into the standardized or tailored rehabilitation group. Both groups will receive a total of 16 sessions over 8 weeks. Follow-up will occur at 4, 8 and 12 weeks after baseline. In this feasibility trial we aim to assess: (1) patients recruitment rate; how any percent of patients agree to participate, patients adherence to the rehabilitation program, and drop-out rates; (2) to obtain the estimates of adverse reactions to treatment; (3) to measure the estimates of intervention effects in order to inform the sample size of the fully-powered RCT.
Interventions
Patients allocated to this group will receive 16 individual, face-to-face sessions, each lasting for 60 min, twice per week, over an 8-week period. The intervention will be delivered by an experienced musculoskeletal physiotherapists.
The intervention consists of sustained mobilization followed by exercises focusing on restoring normal movement pattern and the dynamic stability of the scapulothoracic and glenohumeral joints. The intervention will involve manual therapy techniques focusing on r
Patients allocated to this group will receive 16 individual, face-to-face sessions, each lasting for 60 min, twice per week, over an 8-week period. The intervention will be delivered by an experienced musculoskeletal physiotherapists. The intervention consists of sustained mobilization followed by exercises focusing on restoring normal movement pattern and the dynamic stability of the scapulothoracic and glenohumeral joints. The intervention will involve manual therapy techniques focusing on restoring cervical or thoracic spinal movement, and shoulder and scapular movement to reduce pain, and motor control and progressive resistance training of impaired muscles. Manual therapy techniques and motor control and progressive resistance training will be tailored based on physical impairments presented by the patient, and identified through a thorough physical examination. Progression of dynamic exercises (i.e. concentric-eccentric contractions) will be performed by increasing the number of sets from two to three. Participants will perform a total of 8 strengthening exercises (with two sets of ten repetitions each) and may receive up to three manual therapy techniques per session of treatment. Participants will be asked to perform two types of home-based exercise, with 2-3 sets of 10 repetitions each. The exercises will be tailored to participants' physical impairments. Participants will be asked to perform home-based exercises during the days that they do not attend the physiotherapy session.
Sponsors
University of Otago
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Inclusion and exclusion criteria Patients from 18 years to 65 years old, with mechanical shoulder pain will be recruited to participate in the study. Participants will be screened as per the British Elbow and Shoulder Society (BESS) guidelines. Participants will be included if they present one positive finding on the following tests: (1) Painful arc movement during shoulder flexion or abduction; or (2) pain on resisted lateral rotation or abduction or Jobe’s test.
Exclusion criteria
We will exclude participants with the history of shoulder dislocation, shoulder subluxation, shoulder surgery and cervical surgery within the last 6 months, participants with symptoms of inflammation or systematic disease, signs of paraesthesia in the upper extremities, hemiplegic shoulder pain, frozen shoulder, or positive clinical signs of full thickness rotator cuff tear will be excluded.
Outcome results
None listed