None listed
Conditions
Brief summary
This is a double-blinded (participant and outcome assessor) randomised, sham-controlled trial. Sixty participants with subacromial shoulder pain will be recruited and randomly allocated into the mobilization with movement (MWM) or sham MWM group. The initial treatment effects of MWM and sham MWM on shoulder pain-free range of motion (ROM), pain during movement, maximum ROM, pain at rest, pressure pain threshold, temporal summation of pain and global rating of change scale will be assessed before and after participants received the treatment. The purpose of this study is to explore whether the MWM alone improves clinical outcomes in patients with subacromial shoulder pain, and further explore whether a high-volume MWM leads to better clinical outcomes compared to low-volume MWM. We hypothesize that MWM will lead to better clinical outcomes compared to sham MWM and that high-volume MWM will be more effective than low-volume MWM.
Interventions
Mobilization with movement (MWM):
Participants will attend one session at the the university research-clinic. A registered physiotherapist will deliver this intervention, face-to-face.
Participants allocated to the MWM group will receive 3 sets of 10 repetitions of sustained posterolateral glide MWM technique on the glenohumeral joint. The MWM technique will be applied to the joint while participants perform 3 sets of 10 repetitions of shoulder abduction. We expect participants will take appro
Mobilization with movement (MWM): Participants will attend one session at the the university research-clinic. A registered physiotherapist will deliver this intervention, face-to-face. Participants allocated to the MWM group will receive 3 sets of 10 repetitions of sustained posterolateral glide MWM technique on the glenohumeral joint. The MWM technique will be applied to the joint while participants perform 3 sets of 10 repetitions of shoulder abduction. We expect participants will take approximately 20 seconds to perform 10 repetitions of shoulder abduction. Participants will rest for 60s between each set. The duration of intervention is expected to last for 5 minutes. Participants will sit on a chair while the physiotherapist will stand on the contralateral side of the painful shoulder. The physiotherapist will stabilise the scapula with one hand and place the other hand over the anterior aspect of the head of the humerus. The physiotherapist will sustain the posterolateral glide applied to the gleno-humeral joint while the participant performs shoulder abduction movements. Participants will be informed that the MWM procedure must be pain-free and the technique should be stopped if any painful symptom is experienced during the procedure. If participants present a complete pain-free range of motion in response to the technique, participants will be asked to apply over pressure at the tenth repetition. The overpressure will be performed by having the participant applying pressure on their elbow (on the affected side) using their opposite hand, and sustaining this pressure for 10 seconds. Treatment fidelity will be monitored by clinicians' notes and session attendance checklist.
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 75 Years
Healthy volunteers
No
Inclusion criteria
Participants will be included if they present with painful arc movement during shoulder flexion or abduction; or pain on resisted lateral rotation or abduction; or positive Jobe’s test. To be included, participants also need to respond positively to the application of a posterolateral glide MWM on the shoulder at initial screening. For the purpose of this study, a positive response to MWM is defined as a perceived improvement in pain-free movement by the participant during the application of MWM.
Exclusion criteria
Participants will be excluded if they present signs or symptoms suggesting: acute rotator cuff tear, massive rotator cuff tears (defined by gross shoulder muscle weakness in the absence of pain), history of shoulder or cervical surgery in the past 6 months, corticosteroid injection in the last 6 weeks, other shoulder disorders (i.e., glenohumeral osteoarthritis, history of shoulder subluxation or dislocation, acromioclavicular joint pain, adhesive capsulitis), signs of paresthesia in the upper extremity, systemic inflammation or disease, neurological disease affecting the shoulder, or tumor.
Outcome results
None listed