Apprehension-based Training Compared With Standard Physical Therapy Among Military Personnel Following Anterior Shoulder Dislocation
概览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- Alon Rabin
- 入组人数
- 85
- 试验地点
- 1
- 主要终点
- Return to preinjury level of function
概览
简要总结
The goal of this clinical trial is to determine if a new rehabilitation protocol (apprehension-based training), leads to better recovery after shoulder dislocation among military personnel.
Participants will be randomly allocated to apprehension-based training or standard physical therapy. In apprehension-based training participants will train to control their shoulder under progressively more unstable conditions. Standard physical therapy will be provided based on the clinical judgment of the treating physical therapist The primary hypothesis is that participants undergoing apprehension-based training will experience a more complete recovery of function, better shoulder-related quality of life, and incur less recurrent dislocations.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 39 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 18-39 years
- •Shoulder dislocation (primary or recurrent) documented by a medical practitioner (physician, military medic)
- •Positive anterior apprehension test
- •Gross shoulder muscle strength 3/5 or greater
排除标准
- •Previous shoulder fracture, tendon tear, or shoulder surgery
- •Voluntary shoulder dislocation
- •Functional (Stanmore polar III) shoulder instability
- •Dislocation associated with a motor vehicle accident.
- •Diagnosis of rheumatoid arthritis, cancer (current), fibromyalgia, psychiatric disease)
- •Current pregnancy
- •Inability to attend at least one physical therapy session every 2 weeks.
结局指标
主要结局
Return to preinjury level of function
时间窗: 3 months following the end of intervention
Patient's ability to resume their preinjury military and overall level of function will be assessed separately through a telephone interview 3 months after the end of their assigned intervention. This outcome will be rated dichotomously: "Yes" (have resumed my preinjury military/overall level of function), or "No" (have not been able to resume my preinjury military/overall level of function).
Western Ontario Shoulder Instability Index
时间窗: Baseline to end of intervention (10 weeks) and 1-year follow-up (62 weeks).
The Western Ontario Shoulder Instability Index is a self-reported measure of shoulder instability related quality of life. This questionnaire includes 21 items regarding symptoms, activity limitations, quality of life and emotions. Each item is scored on a 100mm visual analogue scale resulting in a total score of 0 - 2100 which can be converted to a percentage with greater scores indicating greater disability.
Recurrence
时间窗: One year following the end of the intervention
Recurrent events of instability, either in the form of a frank dislocation or a sensation of instability (subluxation) will be assessed through a telephone interview.
Supine moving apprehension test
时间窗: Baseline to end of intervention (10 weeks)
Dynamic stability will be assessed with the supine moving apprehension test. This is a functional performance test in which the patient is asked to repeatedly move the shoulder into 135- and 180-degrees of abduction from a supine position while holding a dumbbell (2-3 kg). The number of repetitions over one minute comprises the score of the test.
次要结局
- Subjective shoulder value(Baseline, end of intervention (10 weeks), and 1-year follow up (62 weeks))
- Tampa scale of kinesiophobia(Baseline, end of intervention (10 weeks), and 1-year follow-up (62 weeks))
- Anterior apprehension test(Baseline to end of intervention (10 weeks))
- Shoulder internal/external rotator muscle strength(Baseline and end of intervention (10 weeks))
- Abdominal rollout(Baseline and end of intervention (10 weeks))
- Heart rate variability(Baseline and end of intervention (10 weeks).)
研究者
Alon Rabin
Principal investigator
Ariel University