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Physiotherapy Program for Managing Adhesive Capsulitis in Patients With Diabetes

Not Applicable
Conditions
Adhesive Capsulitis
Diabetes Mellitus
Interventions
Other: Physical Therapy program
Registration Number
NCT03462420
Lead Sponsor
Western University, Canada
Brief Summary

This pilot randomized trial will compare the preliminary effect of a regular physiotherapy (PT) program to a regular PT combined with a progressive walking program (PT+) in patients with and without diabetes who have adhesive capsulitis. After signing the consent form, recruited participants will be randomized into either PT group (control) or PT+ group (experimental). Participants in both groups will be referred to a physical therapy facility. The intervention will be chosen by treating physical therapist. In PT+ group, participants will also be asked to perform free walking at their own pace. Outcomes measures for the primary outcome (shoulder functional performance) will be evaluated at baseline and after 6 weeks. Secondary outcomes (shoulder ROM, pain and function, muscle strength, and physical activity level) will be evaluated at baseline, at 3 and 6 weeks, and again at 12 weeks after enrolment. We expect adding a progressive walking program to regular PT will result in better outcomes.

Detailed Description

In this pilot randomized clinical trial, participants will be recruited from an Orthopedic clinic at St. Joseph's Health Care Centre via surgeon referrals and from local primary health care clinics via posters advertising the study. Potential participants will be contacted by the research team at Hand and Upper Limb Centre (HULC) to arrange for their initial evaluation and sign a consent form. Participants who agree to participate in this study will be asked to complete 2 outcomes questionnaires (i.e. SPADI, RAPA) and Katz comorbidity scale.

Next, patients will be randomly assigned to one of the two groups: regular Physical Therapy program (PT) or regular PT which add a progressive walking program (PT+). Stratified randomization by diabetic status and sex will be used. All participants will be referred to a physical therapy facility according to their preferences and the intervention will be chosen by the treating physical therapist. In PT+ group, participants will be asked to perform free walking at their own pace for 30-45 min, 5 days per week for 6 consecutive weeks and to record their walking date/time on a diary form provided by the research team before commencing the study. Participants in PT+ group will also be provided with accelerometer to accurately estimate their physical activity level. Outcomes measures for the shoulder functional performance test (primary outcome) will be evaluated at baseline and after 6 weeks. Secondary outcomes (shoulder ROM, pain and function, muscle strength, and physical activity level) will be evaluated at baseline, at 3 and 6 weeks, and again at 12 weeks after enrollment.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Patients with and without diabetes who have adhesive capsulitis
Exclusion Criteria
  • Previous shoulder surgery or dislocation
  • Shoulder severe osteoarthritis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Regular PTPhysical Therapy programParticipants in this group will be referred to a physical therapy facility according to their preferences and the intervention will be chosen by the treating physical therapist. Participants in this group will not be notified about the walking program.
PT+ walkingPhysical Therapy programParticipants in this group will be referred to a physical therapy facility according to their preferences and the intervention will be chosen by the treating physical therapist. In addition, participants will be asked to perform free walking at their own pace for 30-45 min, 5 days per week for 6 consecutive weeks and to record their walking date/time on a diary form provided by the research team before commencing the study. Participants in PT+ group will also be provided with accelerometer to accurately estimate their physical activity level.
Primary Outcome Measures
NameTimeMethod
Change of shoulder performance from baseline to 6 weeks after physiotherapyAt baseline and again after 6 weeks

This test is based on repeated shoulder movements at waist and eye level, and over head work. The test will be performed using Functional Impairment Test- Hand and Neck/ Shoulder/Arm (FIT-HaNSA) tests.

Secondary Outcome Measures
NameTimeMethod
Shoulder pain and functionat baseline, at 3 and 6 weeks, and again at 12 weeks after enrollment

Shoulder pain and function will be assessed using Shoulder Pain and Disability Index (SPADI) questionnaire

Physical activity levelat baseline, at 3 and 6 weeks, and again at 12 weeks after enrollment

The level of activity will be assessed using Rapid Assessment of Physical Activity (RAPA) questionnaire

Shoulder range of motionat baseline, at 3 and 6 weeks, and again at 12 weeks after enrollment

Shoulder range of motion in flexion, abduction, and external rotation

Muscle strengthat baseline, at 3 and 6 weeks, and again at 12 weeks after enrollment

The muscle power of the shoulder flexors and abductors muscles will be assessed

Trial Locations

Locations (1)

St. Joseph's Health Care London

🇨🇦

London, Ontario, Canada

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