None listed
Conditions
Brief summary
Shoulder pain is a common musculoskeletal condition, affecting one third of the world population. The conservative treatment is the first-line intervention, with mobilization with movement being a commonly used intervention in the clinical setting. However, evidence on the effects of mobilization with movement are lacking in the literature. Previous laboratory-based studies have shown that: (1) clinician-administrated sustained shoulder posterolateral glide mobilization offloads shoulder muscles, providing mechanical support to the shoulder; (2) self-administrated sustained shoulder mobilizations lead to similar changes in muscle activity level as clinician-administrated mobilization, supporting the use of home-based mobilization for shoulder rehabilitation; (3) patients with shoulder pain present immediate reduction in pain levels, increased range of motion, and increased muscle activity levels in response to mobilization with movement. Those findings suggest that sustained mobilization temporarily changes the control of scapular and shoulder muscles in asymptomatic and individuals with subacromial shoulder pain. The present proposal aims to advance the current knowledge further by piloting the design of a full trial to test the effectiveness of mobilization with movement on the management of patients with shoulder subacromial pain. This study is a prospective, assessor-blind, parallel-group randomized controlled pilot trial. A total sample size of 24 participants with subacromial shoulder pain will be allocated to mobilization with movement group or a minimal intervention group. Patients in the mobilization with movement group will receive a tailored mobilization with movement technique over 8 weeks, with two treatment sessions per week. Primary outcomes will be participant’s recruitment rate; proportion of participants enrolled from the total number screened; adherence to the allocated intervention; drop-out rate, and treatment fidelity. Participants will be assessed 4 times over 12 weeks (baseline, 4, 8, and 12 weeks). An intention-to-treat analysis approach will be applied for all analyses. Primary outcomes will be presented using descriptive statistics. An independent mixed-model will be conducted for each outcome measure. An implementation-based process evaluation will be assessed by interviewing participants who take part in the study with a thematic qualitative analysis.
Interventions
Participants allocated to this group will receive a best practice advice plus tailored Mobilization With Movement (MWM).
The best practice advice will consists of a one-off clinician consultation session, with the session lasting for approximately 40 min. During that session, the clinician will provide brief information about shoulder pain and will discuss strategies to avoid aggravating their shoulder pain and to self-manage pain. The clinician will answer any questions participants may have a
Participants allocated to this group will receive a best practice advice plus tailored Mobilization With Movement (MWM). The best practice advice will consists of a one-off clinician consultation session, with the session lasting for approximately 40 min. During that session, the clinician will provide brief information about shoulder pain and will discuss strategies to avoid aggravating their shoulder pain and to self-manage pain. The clinician will answer any questions participants may have and will re-assure participants that their condition should improve over time. Participants will receive a pamphlet with information about their condition and basic self-management strategies. The pamphlet will be developed for this study based on the literature and after consulting with clinicians. In that same session, the clinician will deliver the first intervention of MWM. After the first session, participants will receive 15 additional MWM interventions. Those interventions will last approximately 10 min. The MWM technique will be applied over 8 weeks, with two treatment sessions per week (i.e., 1st session lasting for 40 min, followed by 15 sessions lasting 10 min). During each treatment session, 3-5 sets of 6-10 repetitions will be applied, with a rest interval of 1 minute between sets. Information about the MWM technique used will be recorded on a customized sheet by the clinician and will include participants’ position (e.g. sitting, lying, or standing), the MWM techniques used, and the number of sets and repetitions performed.
Sponsors
University of Otago
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
We will include participants aged 18-75 years old with subacromial shoulder pain, who present immediate reduction in shoulder pain following the application of MWM to the shoulder complex (glenohumeral, sternoclavicular, acromioclavicular, and scapulothoracic), cervical spine, or thoracic region. We have defined subacromial shoulder pain and we will screen participants following the British Elbow and Shoulder Society (BESS) guidelines. We will include participants who present with a painful arc movement during shoulder flexion or abduction; or pain on resisted lateral rotation or abduction; or positive Jobe’s test.
Exclusion criteria
We will exclude participants who have acute rotator cuff tear, unreduced dislocation, tumour or infection; or the history of shoulder, cervical surgeries, shoulder subluxation and dislocation; or localised acromioclavicular joint pain, frozen shoulder, hemiplegic shoulder pain, systematic inflammation or disease; or clinical signs of full thickness of rotator cuff tear.
Outcome results
None listed