Exercise in the Physiotherapy Management of Shoulder Impingement (EaSI)

Ulster University

Status: Unknown

Conditions: Subacromial Impingement Syndrome

Treatments: Other: Evidence based exercise protocol; Other: Usual physiotherapy without exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT01691157

11/NI/0026 version 3.1

Details and patient eligibility

About

The purpose of this trial is to investigate the effectiveness of an evidence based exercise program for shoulder impingement. Approximately 1% of adults consult their General Practitioner (GP) with shoulder pain each year, making it the third most common reason for musculoskeletal GP consultations in the UK. A further 50% of these patients are diagnosed with subacromial impingement syndrome (SAIS) (shoulder impingement syndrome) and commonly referred for physiotherapy treatment. This trial aims to compare the effectiveness of an evidence based exercise protocol with usual physiotherapy care.

Full description

Physiotherapy management of shoulder impingement frequently involves exercise, however there is little evidence underpinning exercise prescription and outcomes are poor. Few trials have investigated which muscles should be targeted and how they should be strengthened with respect to the mode, frequency, duration, intensity and progression. This is a randomized controlled trial(RCT) investigating the effectiveness of an evidence based exercise program for shoulder impingement. This research may have an impact on how physiotherapists provide exercise programs to patients with shoulder impingement.

Enrollment: 94 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients must be aged 18 years and older.
• Shoulder pain of at least 3/10 in severity that has been diagnosed by a consultant rheumatologist, orthopaedic surgeon or general practitioner within the past 12 months.
• Positive Hawkins-Kennedy test.
• Positive on testing either supraspinatus (empty can test) or infraspinatus (resisted external rotation in neutral).

Exclusion criteria

• Acute traumatic conditions.
• Evidence of rotator cuff tear (positive drop arm test) or any other shoulder joint pathology (e.g. adhesive capsulitis, labral tears).
• A history of fractures of the upper arm, shoulder or clavicle within the past two years.
• A history of dislocation of the shoulder within the previous two years.
• Postoperative conditions involving the upper arm, shoulder or clavicle.
• Inflammatory or systemic diseases.
• Current signs and symptoms of acute nerve root pain arising from the cervical or upper thoracic spine.
• Previous physiotherapy for the same condition involving an exercise regime.
• Previous corticosteroid injection of the affected shoulder within the past 6 months.
• Unwilling participant.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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94 participants in 2 patient groups

Usual physiotherapy without exercise

Active Comparator group

Description:

Will receive 6 sessions of modified usual physiotherapy care that can consist of any physiotherapeutic modalities normally provided except exercise. this may consist of postural advice, taping, electrotherapy, acupuncture, manual joint mobilizations of the shoulder, cervical or thoracic spine.

Treatment:

Other: Usual physiotherapy without exercise

Exercise

Experimental group

Description:

Will receive an evidence based exercise protocol but no other physiotherapeutic modalities

Treatment:

Other: Evidence based exercise protocol