RecruitingACTRN12615000704594

Exercise intervention for subacromial impingement syndrome. A randomised controlled trial of two rehabilitation protocols.

Is an intervention consisting of up to 3 pain free exercises equivalent to a standard evidence based protocol in regards to pain, function and compliance for patients aged between 30 and 65 with intermittent unilateral shoulder pain and positive impingement tests.

Sponsor

Fairfield Hospital

Enrollment

160 participants

Start Date

Jul 28, 2015

Study Type

Interventional

Conditions

Shoulder impingement syndrome

Summary

Exercise therapy has been shown to be effective in treating subacromial impingement syndrome. The purpose of this research project is to compare two different exercise treatment protocols. The first protocol has been researched and shown to be of benefit. The second protocol has a sound physiological basis and has been used by therapists for many years. This will be the first time it has been the subject of a research project. If proven to be effective the second protocol will simplify the treatment of subacromial impingement syndrome.

Eligibility

Sex: Both males and femalesMin Age: 30 YearssMax Age: 65 Yearss

Inclusion Criteria5

Referred for physiotherapy treatment and
a) Aged between 30-65
b) Pain is intermittent
c) Pain behaves mechanically
d) Positive for impingement signs; Hawkins-Kennedy Test, Neers Test, Painful arc and Allingham's Test

Exclusion Criteria12

a) Suspected or diagnosed pathologies arising from vertebral column structures.
b) Diagnoses of neoplastic disorders.
c) Pain potentially from inflammatory (including adhesive capsulitis) or neurogenic origin.
d) Clinical features (Murrell and Walton 2001) or radiological evidence of rotator cuff tear.
e)Shoulder trauma, or cervical or upper thoracic spine injury in the previous 12 weeks.
f) Previous shoulder dislocation.
g) Previous CVA.
h) Severe pain that prevents exercises from being undertaken.
i) Bilateral shoulder pain (since comparison with the contralateral side is required for certain outcome measurements).
j) Inability to provide informed consent.
k) Patients who decline to comply with an exercise program.
l) Patients who do not speak English, Vietnamese or Arabic.

Interested in this trial?

Get notified about updates and connect with the research team.

Interventions

Subjects will be given individualised exercises according to a protocol that: excludes exercise in the presence of pain and excludes exercises that reduce the subacromial space. There are 2 standard

Subjects will be given individualised exercises according to a protocol that: excludes exercise in the presence of pain and excludes exercises that reduce the subacromial space. There are 2 standard exercises- Elastic resisted adduction and extension and an optional 3rd exercise (internal rotation against elastic resistance). Participants will attend a maximum of 8 physiotherapy session over 12 weeks. No manual therapy is performed at physiotherapy sessions. The initial physiotherapy session will be for 1 hour with subsequent visits being 30 minutes. Exercises are performed as a home exercise programme using elastic supplied to the participant. Subjects are asked to aim to complete the exercises every 2 hrs. Exercises are started at repetitions determined by the physiotherapist with an aim of 10-15 repetitions per occasion per exercise. Physiotherapists are provided with the following directions regarding progression: * Do not progress elastic resistance * Add internal rotation if not prescribed at start of programme * Can increase repetitions up to 20-25 per exercise per occasion * Can increase ROM through which exercises are performed Participants are encouraged to continue exercises after 12 weeks according to previous instructions regarding maintenance exercise. A self reported exercise diary will be used to monitor and record compliance.