Exercise in the Physiotherapy Management of Shoulder Impingement (EaSI)

Study Description

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

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.

Condition or disease	Intervention/treatment	Phase
Subacromial Impingement Syndrome	Other: Evidence based exercise protocol; Other: Usual physiotherapy without exercise	Not Applicable

Detailed 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.

Study Design

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Study Type :	Interventional (Clinical Trial)
Estimated Enrollment :	94 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Single (Outcomes Assessor)
Primary Purpose:	Treatment
Official Title:	The Effectiveness of Exercise in the Physiotherapy Management of Subacromial Impingement Syndrome
Study Start Date :	September 2012
Estimated Primary Completion Date :	May 2013
Estimated Study Completion Date :	May 2013

Arms and Interventions

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Arm	Intervention/treatment
Active Comparator: Usual physiotherapy without exercise; 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.	Other: Usual physiotherapy without exercise; Will receive 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.; Other Name: Usual care
Experimental: Exercise; Will receive an evidence based exercise protocol but no other physiotherapeutic modalities	Other: Evidence based exercise protocol; An evidence based graduated exercise rehabilitation protocol will be provided and supervised by a physiotherapist. patients will receive 6 sessions of supervised physiotherapy

Outcome Measures

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Primary Outcome Measures :

1. change from baseline in average pain scores at rest and at night using 100mm visual analogue scale (VAS). [ Time Frame: Outcomes measured at 0, 6 and 12 weeks ]
   Primary outcome measure: Average pain scores at rest and at night for the week prior to measurement will be recorded using a 100mm visual analogue scale (VAS). The change in pain scores at 6 and 12 weeks from baseline will be measured.

Secondary Outcome Measures :

1. Western Ontario Rotator Cuff Index (WORC [ Time Frame: 0, 6 and 12 weeks ]
   Secondary outcome measures will focus on function, disability and quality of life, consisting of a combination of generic, region specific and disease-specific health questionnaires. The change in scores from baseline will be measured.
2. The American Shoulder and Elbow Surgeons function score. [ Time Frame: 0. 6 and 12 weeks ]
   Limb specific outcome measure
3. SF-36 Health Survey • SF-36 Health Survey [ Time Frame: 0, 6 and 12 weeks ]
   Generic measure of health status
4. Isometric strength and range of movement of shoulder flexion, abduction, external rotation and internal rotation using a hand held dynamometer. [ Time Frame: 0, 6 and 12 weeks ]
   objective measures of strength and ROM

Eligibility Criteria

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

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.

Contacts and Locations

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Contacts

Contact: Catherine E Hanratty, BSc Hons	0044 2890 368732	hanratty-c@email.ulster.ac.uk
Contact: Joseph G McVeigh, BSc Hons	0044 2890 368148	j.mcveigh@ulster.ac.uk

Locations

United Kingdom
Musgrave Park Hospital	Recruiting
Belfast, N.Ireland, United Kingdom, BT9 7JB
Contact: Ingrid Traynor, Physio 0044289090 ext 2078 ingrid.traynor@belfasttrust.hscni.net
The Waveney Hospital	Recruiting
Ballymena, N.I, United Kingdom
Contact: Colin Brennan, physio 00442870347853 colin.brennan@hscni.net
Robinson Memorial Hospital	Recruiting
Ballymoney, N.I, United Kingdom, BT53 6HB
Contact: Colin Brennan, Physio 00442870347853 colin.brennan@northerntrust.hscni.net
The Fort Centre, Physiotherapy Department	Recruiting
Coleraine, N.I, United Kingdom
Contact: Colin Brennan, Physio 00442870347853 colin.brennan@hscni.net

Sponsors and Collaborators

University of Ulster

Belfast Health and Social Care Trust

Northern Health and Social Care Trust

Mayo Clinic

Keele University

Investigators

Principal Investigator:	Joseph G McVeigh, BSc Hons	University of Ulster

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Responsible Party:	Dr Joseph G McVeigh, Lecturer in Physiotherapy and PhD supervisor, University of Ulster
ClinicalTrials.gov Identifier:	NCT01691157 History of Changes
Other Study ID Numbers:	11/NI/0026 version 3.1
First Posted:	September 24, 2012
Last Update Posted:	October 12, 2012
Last Verified:	October 2012

Keywords provided by Dr Joseph G McVeigh, University of Ulster:

Subacromial impingement syndrome; Rotator cuff; Exercise; Physiotherapy

Additional relevant MeSH terms:

Syndrome; Rotator Cuff Injuries; Shoulder Impingement Syndrome; Disease; Pathologic Processes; Rupture	Wounds and Injuries; Shoulder Injuries; Tendon Injuries; Joint Diseases; Musculoskeletal Diseases