Apprehension-based Training Compared With Standard Physical Therapy for Military Personnel Following Anterior Shoulder Dislocation - a Randomized Clinical Trial

Alon Rabin

Status: Enrolling

Conditions: Anterior Shoulder Dislocation

Treatments: Behavioral: Apprehension-based training; Behavioral: Standard physical therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT06752551

2388-2023

Details and patient eligibility

About

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.

Enrollment: 85 estimated patients

Sex: All

Ages: 18 to 39 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 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

Exclusion criteria

• 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.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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85 participants in 2 patient groups

Apprehension-based training

Experimental group

Description:

Apprehension-based training is a 3-phase exercise intervention intended to expose patients to progressively increased shoulder apprehension-provoking conditions. Patients progress from one phase to the other upon completion of the previous level of exercise

Treatment:

Behavioral: Apprehension-based training

Standard physical therapy

Active Comparator group

Description:

Standard physical therapy will be provided by a licensed physical therapist and may include exercises of different kinds, manual therapy, dry needling or electrophysiological modalities.

Treatment:

Behavioral: Standard physical therapy