MedPath

Self-Management for Persistent Subacromial Pain

Phase 1
Completed
Conditions
Shoulder Pain Chronic
Registration Number
NCT04190836
Lead Sponsor
Oslo Metropolitan University
Brief Summary

Physiotherapy-led exercises is the first line treatment for patients with subacromial pain. However, current evidence report that most treatment programmes only show a short-term benefit. There seem to be a potential for enhancing the effectiveness of exercise interventions by improving adherence to self-managed exercises, but there is lack of knowledge about adherence to exercise programmes in shoulder pain. Before conducting a planned randomised controlled trial on the clinical effectiveness of an intervention focusing on adherence to a self-managed exercise strategy (the Ad-Shoulder intervention), it is necessary to run a feasibility study in order to establish whether such a resource-demanding trial is worthwhile. Feasibility studies are designed to answer the key question "Can it work?" The main objectives of the present study was to assess the feasibility in terms of recruitment capability, data collection procedures and acceptability of the Ad-Shoulder intervention in patients with subacromial pain receiving treatment in primary or secondary health care.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
11
Inclusion Criteria
  • Pain located to the upper arm
  • Had previously received conservative treatment due to subacromial pain
  • Still seek primary or secondary care during the past 6 months
Exclusion Criteria
  • Frozen shoulder diagnosis (<50% external rotation compared to contralateral side)
  • Patients who have received surgical treatment due to shoulder problems
  • Pregnant patients
  • Patients with insufficient Norwegian language skills
  • Serious psychiatric disorder

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
Follow-up rate3 months

Determine the follow-up rate - measured by the percentage of participants who were followed up successfully until the three months follow-up

Adherence3 months

Determine whether the patients adhere with the self-managed exercises - measured by self-reported exercise log book

Recruitment rate3 months

How many people that were eligible and how many people that were recruited per week

Actigraph assessment of physical activity3 months

Feasibility of Actigraph assessment of physical activity - measured by percentage of participants with valid data at Week 0, Week 6 and 3 months

Fidelity3 months

Determine whether the therapists delivered the intervention as planned - measured by assessing the therapists' log book

Adverse events3 months

Determine number and nature of adverse events via self-report questionnaire

Secondary Outcome Measures
NameTimeMethod
Physical activity (self-reported)3 months

Physical activity will be assessed by the 3 questions from the Nord-Trondelag Health Study (HUNT) regarding frequency, intensity and duration.

Shoulder pain and disability index (SPADI)3 months

SPADI is a self-reported questionnaire for patients with shoulder pain. The questionnaire consists of 13 questions divided into two domains: pain (five items) and function (eight items) and scored on a numerical scale 0 (best) to 10 (worst) with a score range from 0 to 100 points

Numeric Pain Rating Scale (NPRS)3 months

Pain intensity during the last week was measured using the NPRS (ranging from 0 = no pain, 10 = the most intense pain imaginable). Repeated measures: During a one week pre-treatment phase (A), 3 times. During the 12 week treatment phase (B): collected twice every week. During a one week post-treatment phase (A): 3 times

Kinesiophobia3 months

Kinesiophobia will be assessed using one question: "How much 'fear' do you have that these complaints would be increased by physical activity? (scores range from 0 = no fear, to 10 = very much fear).

EQ-5D-5L3 months

Generic health-related quality of life will be assessed by the EQ-5D. It evaluates 5 dimensions: mobility, self-care, activities of daily living, pain, and anxiety and/or depression. For each dimension the patient describes three possible levels of problems (none, mild-to-moderate, and severe).

Bergen Insomnia Scale3 months

Pain-interference with sleep will be assessed by the Bergen Insomnia Scale, which consists of six items. Scoring 3 or above on at least one of the first four items and scoring 3 or above on at least one of the last two items indicate the presence of insomnia.

Working Ability Index3 months

Work ability will be measured on a 11-point scale (0 = Can not work at all, 10 = working ability is best right now)

Patient Specific Function Scale (PSFS)3 months

PSFS is a patient specific outcome measure where the patient is asked to name three activities which the patient find challenging or are not able to do because of their shoulder pain. Patients rate their ability to complete the activities on a 11-point scale at a level experienced prior to injury or change in functional status. "0" represents "unable to perform" and "10" represents "able to perform at prior level".

Pain self-efficacy 2-item short form (PSEQ-2 item)3 months

Measured using a 2-item questionnaire by asking the patients' how confident they are doing some form of work and to live a normal lifestyle at present, despite the pain (ranging from 0 = not at all confident, 6 = completely confident). Repeated measures: During a one week pre-treatment phase (A), 3 times. During the 12 week treatment phase (B): collected twice every week. During a one week post-treatment phase (A): 3 times

Self-efficacy3 months

Measured using one modified question from the Musculoskeletal Health Questionnaire: "How confident have you felt about managing your shoulder pain by yourself (responses were not at all confident, slightly, moderately, very and extremely)? Repeated measures: During a one week pre-treatment phase (A), 3 times. During the 12 week treatment phase (B): collected twice every week. During a one week post-treatment phase (A): 3 times

Global Perceived Effect scale (GPE)3 months

The patient rated perception of change at the follow-ups will be assessed on a Global Perceived Effect scale (GPE) at follow-up (52). The response alternatives were: 1 = "completely recovered", 2 = "much improved", 3 = "slightly improved", 4 = "no change", 5 = "slightly worse", 6 = "much worse", and 7 = "worse than ever".

Physical activity (accelerometer)3 months

To objectively measure physical activity an accelerometer (AX3, 3-axis Logging Accelerometer) was used. This accelerometer provides information about movement and will enable us to objectively measure the amount of general physical activity (minutes of moderate activity). The patients will be measured for three consecutive days at baseline, at 6 weeks and at 3 months to assess changes between the three time points (Week 0, Week 6 and 3 months.

Trial Locations

Locations (2)

Diakonhjemmet Hospital

🇳🇴

Oslo, Norway

Oslo Metropolitan University

🇳🇴

Oslo, Norway

Diakonhjemmet Hospital
🇳🇴Oslo, Norway

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