Our review provides anchor-based MID estimates , as well as a rating of their credibility , for PROMs for patients with shoulder conditions .
The MID estimates inform the interpretation for a linked systematic review and guideline addressing subacromial decompression surgery for shoulder pain , and could also prove useful for authors addressing other interventions for shoulder problems .
OBJECTIVES To identify credible anchor-based minimal important differences ( MIDs ) for  patient-reported outcome measures  ( PROMs ) relevant to a BMJ Rapid Recommendations addressing subacromial decompression surgery for shoulder pain .
A comparison of isometric, isotonic concentric and isotonic eccentric exercises in the physiotherapy management of subacromial pain syndrome/rotator cuff tendinopathy: study protocol for a pilot randomised controlled trial
Background Subacromial pain syndrome ( SPS ) involving rotator cuff tendinopathy is a common cause of shoulder pain and disability . Evidence suggests that structured physiotherapy may be as effective as surgery in this condition with significant improvements demonstrated in trials involving scapular retraining , rotator cuff strengthening and flexibility exercises . Most published programs typically utilise isotonic concentric and /or eccentric strengthening modes . Recently , immediate analgesic effects and muscle strength gains following heavy-load isometric exercises in lower limb tendinopathy conditions have been observed . It is pertinent to ascertain whether such outcomes can be replicated in SPS/rotator cuff tendinopathy . The primary aim of this study is to establish the feasibility of undertaking a full-scale r and omised controlled trial ( RCT ) that compares the effects of isometric , isotonic concentric and isotonic eccentric rotator cuff contractions when used as part of a semi-st and ardised exercise-based physiotherapy program in patients diagnosed with SPS . The secondary aim is to explore potential trends or treatment effects of the exercise intervention . Methods Thirty-six participants diagnosed with SPS will be r and omised to one of three intervention groups and undergo a one-on-one exercise-based physiotherapy intervention , involving scapular and rotator cuff muscle retraining and strengthening . Each group will utilise a different mode of rotator cuff strengthening — isometric , isotonic concentric or isotonic eccentric . Rotator cuff tendon responses to isometric loading are not yet established in the literature ; hence , individualised , progressive loading will be used in this pilot study in accordance with symptoms . The intervention will involve two phases : during Phase 1 ( weeks 1–6 ) participants undertake the active group-specific physiotherapy treatment ; in Phase 2 ( weeks 6–12 ) , they undertake a progressive , but no longer group-specific exercise program . To determine feasibility , an evaluation of key study parameters including ( a ) ease of recruitment ( rate and number as well as suitability of the assessment algorithm ) , ( b ) adherence to all phases of the exercise intervention including home program compliance and logbook completion , ( c ) participant non-completion ( drop out number and rate ) and ( d ) adverse events ( nature and number ) will be undertaken . Secondary outcomes will measure immediate effects : ( i ) within-treatment changes in pain perception ( verbal rating scale ( VRS ) and shoulder muscle strength ( h and -held dynamometer ) as well as longer-term changes : ( ii ) shoulder-related symptoms and disability ( Western Ontario Rotator Cuff Index ( WORC ) and Shoulder Pain and Disability Index ( SPADI ) ) , ( iii ) perception of pain ( 11-point numerical rating scale ( NRS ) , ( iv ) shoulder muscle strength ( h and -held dynamometer ) and ( v ) perceived global rating of change score . The immediate within-treatment assessment of pain and muscle strength will be undertaken in treatments 2 and 3 , and the longer term measures will be collected at the primary ( conclusion of Phase 1 at 6 weeks ) and secondary ( conclusion of Phase 2 at 12 weeks ) end-points of the study . Discussion The findings of this pilot study will permit evaluation of this study design for a full-scale RCT .Trial registration Australian New Zeal and Clinical Trials Registry ,
Our review provides anchor-based MID estimates , as well as a rating of their credibility , for PROMs for patients with shoulder conditions .
The MID estimates inform the interpretation for a linked systematic review and guideline addressing subacromial decompression surgery for shoulder pain , and could also prove useful for authors addressing other interventions for shoulder problems .
OBJECTIVES To identify credible anchor-based minimal important differences ( MIDs ) for  patient-reported outcome measures  ( PROMs ) relevant to a BMJ Rapid Recommendations addressing subacromial decompression surgery for shoulder pain .