Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Does the Need of Arthroscopic Subacromial Decompression Change After Eccentric Physical Therapy Exercises in Patients With Subacromial Pain? - A Randomized Clinical Trial
Brief Summary: Objective:

A randomized clinical trial in order to evaluate the efficacy of structured eccentric exercises tutored by a physical therapist (PT) for patients with subacromial impingement.

Hypothesis:

H1 The exercises has a satisfactory effect and the need of an arthroscopic subacromial decompression can be reconsidered.

H0 No difference between the two exercises (experimental and active control) and the patients still need surgery

Further the study objective is to evaluate predictors for a positive or negative treatment response after three months of rehabilitation as well as after 12 months.

Method:

Patients referred to the orthopedic unit for an arthroscopic subacromial decompression, are offered a three month rehabilitation program during the waiting time for surgery which is approximately 4-6 months. All patients must have tried conservative treatments for at least 6 months in primary care with unsatisfactory results. The patients will be randomized to either the structured eccentric exercises tutored by a physical therapist or control exercises with general movements for the neck and shoulders. All patients has an equal number of sessions with the PT to offer similar attention. After three months the following key-question has to be answered: due to your current experience of your shoulder problems do you still need this surgical intervention? A blinded orthopedic surgeon evaluates the following outcomes at baseline and after three and twelve months. Primary outcomes: Constant-Murley shoulder assessment, Disabilities of the Arm Shoulder and Hans and different aspects of pain. Secondary outcomes; EQ-5D, sick-leave and return to work. All patients are evaluated with a diagnostic ultrasound in order to reveal the condition of the rotator cuff. Also long-term results in those who go thorough with the surgery and those who decline will be assessed after 12 months.

Importance of the study results:

Since there is no consensus about which intervention that should be preferred for patients with subacromial impingement the results of the current study is warranted. If this exercise program is successful it can be implemented into clinical practice. Further, clinical characteristics of patients that really need an arthroscopic subacromial decompression can be identified.


Options:
A: Arm Label: A; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Physical therapy method called Supervised Exercises | Arm Label: B; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Radial Extracorporeal Shockwave Therapy | Intervention Type: PROCEDURE; Name: Physical therapy method called Supervised Exercises; Assigned to Arm(s): A | Intervention Type: PROCEDURE; Name: Radial Extracorporeal Shockwave Therapy; Assigned to Arm(s): B
B: Arm Label: Arthroscopic Sub-acromial Decompression; Type: EXPERIMENTAL; Interventions: Procedure: Arthroscopic Sub-acromial Decompression Surgery | Arm Label: Shoulder Arthroscopy; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Shoulder Arthroscopy | Arm Label: Active Monitoring with Specialist Reassessment; Type: OTHER; Interventions: Other: Active Monitoring with Specialist Reassessment | Intervention Type: PROCEDURE; Name: Arthroscopic Sub-acromial Decompression Surgery; Assigned to Arm(s): Arthroscopic Sub-acromial Decompression | Intervention Type: PROCEDURE; Name: Shoulder Arthroscopy; Assigned to Arm(s): Shoulder Arthroscopy | Intervention Type: OTHER; Name: Active Monitoring with Specialist Reassessment; Assigned to Arm(s): Active Monitoring with Specialist Reassessment
C: Arm Label: Active physiotherapy; Type: EXPERIMENTAL; Interventions: Procedure: Physiotherapy program | Arm Label: Placebo physiotherapy; Type: PLACEBO_COMPARATOR; Interventions: Procedure: Placebo physiotherapy treatment | Intervention Type: PROCEDURE; Name: Physiotherapy program; Assigned to Arm(s): Active physiotherapy | Intervention Type: PROCEDURE; Name: Placebo physiotherapy treatment; Assigned to Arm(s): Placebo physiotherapy
D: Arm Label: PT progressive exercises; Type: EXPERIMENTAL; Interventions: Procedure: Exercise program | Arm Label: Movement exercises neck and shoulder; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Exercise program, Procedure: Movement exercises | Intervention Type: PROCEDURE; Name: Exercise program; Assigned to Arm(s): Movement exercises neck and shoulder, PT progressive exercises | Intervention Type: PROCEDURE; Name: Movement exercises; Assigned to Arm(s): Movement exercises neck and shoulder

Answer: D