Exercise Into Pain in Subacromial Shoulder Pain: a Randomized Controlled Trial
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Shoulder Impingement Syndrome
- Sponsor
- Universiteit Antwerpen
- Enrollment
- 43
- Locations
- 1
- Primary Endpoint
- Shoulder Pain and Disability Index (SPADI)
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
The aim of the randomized clinical trial is to investigate if "exercising into pain" gives better results in term of clinical outcomes compared to a non-painful exercise program.
Detailed Description
Exercise therapy is the first choice of treatment in the treatment of subacromial shoulder pain (SSP). Guidelines suggest exercise therapy for at least three months and research underlines the importance of progressive loaded exercise therapy at high dosage. However, it is not clear which is the best type of exercise and if pain should be provoked or avoided during exercise. Recent research found that painful exercises are beneficial in short term on pain and function in patients with different kinds of chronic musculoskeletal pain. The aim is to investigate if one painful exercise can give better and faster results in the management of SSP than non-painful program.
Investigators
Filip Struyf
Professor
Universiteit Antwerpen
Eligibility Criteria
Inclusion Criteria
- •shoulder pain for at least 3 months, elicited in the anterolateral shoulder region
- •at least 3 out of 5 of the following tests positive: Neer test, Hawkins-Kennedy, Jobe, painful arc, external resistance test
- •resting pain should be at 2/10 maximum on verbal numerical pain rating scale (NPRS)
Exclusion Criteria
- •bilateral shoulder pain
- •corticosteroid injections 6 weeks prior to the study
- •pregnancy, inability to understand spoken or written Dutch
- •clinical signs of full-thickness rotator cuff tears (positive external and internal rotation lag tests and drop arm test)
- •evidence of adhesive capsulitis
- •previous cervical, thoracic or shoulder surgery; recent fractures or dislocations on the painful shoulder
- •primary complaint of spinal pain or signs of central nervous system involvement or signs of cervical nerve root involvement; reproduction of shoulder pain with cervical rotation or axial compression
- •primary diagnosis of acromioclavicular pathology, shoulder instability
- •a radiologically confirmed fracture or previous medical imaging confirming the presence of calcification larger than 5 mm
- •presence of competing pathologies (inflammatory arthritis, neurological disorders, fibromyalgia, malignancy, psychiatric illness, osteoporosis, hemophilia, rheumatic polymyalgia)
Outcomes
Primary Outcomes
Shoulder Pain and Disability Index (SPADI)
Time Frame: Change from baseline to 12 weeks
There are 13 items, divided in two subscales: pain (5 items) and function (8 items). Each item is scored from 0 (no pain/no difficulty) to 10 (worst imaginable pain/so difficult it requires help) on a NPRS. The final score is a percentage derived from an average of the two subscales, where higher score means worse outcome.
Secondary Outcomes
- Maximum Voluntary Contraction (MVC) in internal rotation, external rotation, scaption(Change from baseline to 6 months)
- Scapular Correction(Change from baseline to 6 months)
- Supraspinatus Tendon Thickness(Change from baseline to 6 months)
- Visual Analogue Scale (VAS)(Change from baseline to 6 months)
- Health-Related Quality of Life(Change from baseline to 6 months)
- Fear-Avoidance Beliefs Questionnaire (FABQ)(Change from baseline to 6 months)
- Scapular Dyskinesis(Change from baseline to 6 months)
- Acromiohumeral Distance(Change from baseline to 6 months)
- Fear of Pain Questionnaire (FPQ-9)(Change from baseline to 6 months)
- Range of Movement (ROM) in internal rotation, external rotation, scaption(Change from baseline to 6 months)
- Coracohumeral distance(Change from baseline to 6 months)
- Subscapularis Tendon Thickness(Change from baseline to 6 months)
- Shoulder Pain and Disability Index (SPADI)(Change from baseline to 6 months)