Subacromial Impingement Syndrome
Conditions
Keywords
Subacromial impingement syndrome, Rotator cuff, Exercise, Physiotherapy
Brief summary
The purpose of this trial is to investigate the effectiveness of an evidence based exercise program for shoulder impingement. Approximately 1% of adults consult their General Practitioner (GP) with shoulder pain each year, making it the third most common reason for musculoskeletal GP consultations in the UK. A further 50% of these patients are diagnosed with subacromial impingement syndrome (SAIS) (shoulder impingement syndrome) and commonly referred for physiotherapy treatment. This trial aims to compare the effectiveness of an evidence based exercise protocol with usual physiotherapy care.
Detailed description
Physiotherapy management of shoulder impingement frequently involves exercise, however there is little evidence underpinning exercise prescription and outcomes are poor. Few trials have investigated which muscles should be targeted and how they should be strengthened with respect to the mode, frequency, duration, intensity and progression. This is a randomized controlled trial(RCT) investigating the effectiveness of an evidence based exercise program for shoulder impingement. This research may have an impact on how physiotherapists provide exercise programs to patients with shoulder impingement.
Interventions
OTHEREvidence based exercise protocol
An evidence based graduated exercise rehabilitation protocol will be provided and supervised by a physiotherapist. patients will receive 6 sessions of supervised physiotherapy
OTHERUsual physiotherapy without exercise
Will receive modified usual physiotherapy care that can consist of any physiotherapeutic modalities normally provided except exercise. this may consist of postural advice, taping, electrotherapy, acupuncture, manual joint mobilizations of the shoulder, cervical or thoracic spine.
Sponsors
Belfast Health and Social Care Trust
Northern Health and Social Care Trust
Mayo Clinic
Keele University
University of Ulster
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients must be aged 18 years and older. * Shoulder pain of at least 3/10 in severity that has been diagnosed by a consultant rheumatologist, orthopaedic surgeon or general practitioner within the past 12 months. * Positive Hawkins-Kennedy test. * Positive on testing either supraspinatus (empty can test) or infraspinatus (resisted external rotation in neutral).
Exclusion criteria
* Acute traumatic conditions. * Evidence of rotator cuff tear (positive drop arm test) or any other shoulder joint pathology (e.g. adhesive capsulitis, labral tears). * A history of fractures of the upper arm, shoulder or clavicle within the past two years. * A history of dislocation of the shoulder within the previous two years. * Postoperative conditions involving the upper arm, shoulder or clavicle. * Inflammatory or systemic diseases. * Current signs and symptoms of acute nerve root pain arising from the cervical or upper thoracic spine. * Previous physiotherapy for the same condition involving an exercise regime. * Previous corticosteroid injection of the affected shoulder within the past 6 months. * Unwilling participant.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change from baseline in average pain scores at rest and at night using 100mm visual analogue scale (VAS). | Outcomes measured at 0, 6 and 12 weeks | Primary outcome measure: Average pain scores at rest and at night for the week prior to measurement will be recorded using a 100mm visual analogue scale (VAS). The change in pain scores at 6 and 12 weeks from baseline will be measured. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Western Ontario Rotator Cuff Index (WORC | 0, 6 and 12 weeks | Secondary outcome measures will focus on function, disability and quality of life, consisting of a combination of generic, region specific and disease-specific health questionnaires. The change in scores from baseline will be measured. |
| The American Shoulder and Elbow Surgeons function score. | 0. 6 and 12 weeks | Limb specific outcome measure |
| SF-36 Health Survey • SF-36 Health Survey | 0, 6 and 12 weeks | Generic measure of health status |
| Isometric strength and range of movement of shoulder flexion, abduction, external rotation and internal rotation using a hand held dynamometer. | 0, 6 and 12 weeks | objective measures of strength and ROM |
Countries
United Kingdom
Contacts
Primary ContactCatherine E Hanratty, BSc Hons
Backup ContactJoseph G McVeigh, BSc Hons
Outcome results
None listed