RecruitingNot ApplicableNCT06661681

Cognitive Functional Therapy for Treating Individuals With Chronic Shoulder Pain

Cognitive Functional Therapy Versus Therapeutic Exercises for the Treatment of Individuals With Chronic Shoulder Pain: A Randomized Controlled Trial

Sponsor

Federal University of Paraíba

Enrollment

72 participants

Start Date

Feb 17, 2025

Study Type

INTERVENTIONAL

Conditions

Exercise Therapy Chronic Shoulder Pain Psychosocial Rehabilitation

Summary

Shoulder pain is a debilitating musculoskeletal condition with functional, physical, and psychological impacts. Interventions for chronic shoulder pain should address the biopsychosocial model, with Cognitive Functional Therapy emerging as a promising physiotherapy approach. Cognitive Functional Therapy approaches the multidimensional nature of pain, integrating physical and cognitive aspects. The aim of this randomized controlled trial is to compare the effects of Cognitive Functional Therapy with therapeutic exercise on biological aspects of pain (pain intensity, disability, function, perception of improvement/deterioration, and central pain processing), and psychosocial aspects of pain (sleep quality, self-efficacy, and biopsychosocial factors). The hypothesis of this study is that CFT will lead to greater improvements in these outcomes compared to therapeutic exercise.

Eligibility

Min Age: 18 YearsMax Age: 60 Years

Inclusion Criteria5

Men or women;
Age between 18 and 60 years;
Presence of shoulder pain for more than 3 months;
Pain intensity of 4 points or more on the 11-point Numeric Pain Rating Scale.
High level of disability or moderate level of irritability.

Exclusion Criteria9

History of fracture or surgery of the clavicle, scapula, and/or humerus, surgical stabilization or rotator cuff repair;
History of dislocation, instability (positive sulcus sign or apprehension test), and/or rotator cuff tear (positive drop arm test);
Adhesive capsulitis verified by the presence of gradual onset pain associated with stiffness and reduced passive and active mobility;
Ongoing pregnancy;
Reproduction of shoulder pain radiating to the entire upper limb during cervical or thoracic spine tests (positive Spurling test);
Neurological or systemic diseases that may alter muscle strength and sensitivity such as rheumatoid arthritis, fibromyalgia, lupus, gout, and diabetes;
Corticosteroid injection in the shoulder region in the last 3 months;
Physiotherapy treatment in the last 6 months.
Active treatment for cancer

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Interventions

BEHAVIORALCognitive Functional Therapy (CFT)

Cognitive Functional Therapy (CFT) is underpinned by a strong therapeutic alliance, active listening, and motivational interviewing style, covering the following domains: i) Making sense of pain involves discussing the multidimensional nature of persistent pain, as well as the beliefs, emotions, and behaviors that can perpetuate the vicious cycle of pain and disability. ii) Exposure with control involves a functional training designed to normalize maladaptive and provocative postural and movement behaviors, where individuals will learn strategies to improve their body awareness and control and modify postures and tasks commonly associated with pain. iii) Lifestyle change aims to help patients embrace a healthy lifestyle, which will include promoting a gradual increase in physical activity, sleep hygiene counseling, stress management strategies, and social re-engagement.

OTHERTherapeutic exercises group

Each session will include stretching exercises targeting the following muscles i) Upper trapezius; ii) Pectoralis minor; iii) Posterior shoulder region, and strengthening exercises targeting the following muscles i) Lower trapezius, ii) Middle trapezius, iii) Serratus punch exercise, iv) Shoulder external rotators, and v) Shoulder internal rotators.