Supervised Exercise Therapy vs Home Exercises for Patients With Subacromial Impingement

Study Overview
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Brief Summary
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The purpose of this study is to determine whether there are any difference between supervised exercise therapy and homebased exercise when looking at pain and function for patients with shoulder pain.

Detailed Description
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Shoulder pain is common in the population. Various treatment modalities are used. According to the literature, it is equally good results for home exercises and for guided exercise therapy. The purpose of this study is to look at this again and determine whether there are any difference between supervised exercise therapy and homebased exercise when looking at pain and function for patients with subacromial impingement.

Official Title
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Is Supervised Exercise Therapy a Better Option Than Home Exercises for Patients With Subacromial Impingement When Looking at Pain and Function?

Conditions
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Shoulder Impingement Syndrome

Intervention / Treatment
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* Other: supervised exercise
* Other: homebased exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pain in one shoulder Had the condition for more than 12 weeks Pain at abduction (must be present in some part between 60 and 120 degrees) Pain/ weakness in isometric external rotation Positive Hawkins test Exclusion Criteria: Instability Labral pathology Acromioclavicular joint (AC-joint) pathology Complete rupture in the rotatorcuff Glenohumeral osteoarthritis Previously operated on current shoulder The pain comes from neck pathology Rheumatoid arthritis or other serious physical or mental illness Lack of Norwegian language Unable to start

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: supervised exercise<br>The group gets 10 supervised exerciseclasses at the physiotherapy clinic in addition to homebased exercises | Other: supervised exercise<br>* This group will receive 10 classes of supervised exercise in the 6 weeks intervention. In this classes the patients will be with a physiotherapist that will adjust their home-exercise program and make sure they do the exercises in a good way. They will receive 4-6 exercises they shall do 3 times with 30 repetitions, 2 times every day. If necessary, they should also do stretching exercises<br>|
| Experimental: homebased exercises<br>The group gets 1 supervised exerciseclass before they do all their exercises at home | Other: homebased exercises<br>* This group will receive 1 class of supervised exercise at the beginning of the 6 weeks intervention. In this class the patients will be with a physiotherapist that will put together a home-exercise program and make sure they do the exercises in a good way. They will receive 4-6 exercises they shall do 3 times with 30 repetitions, 2 times every day. If necessary, they should also do stretching exercises<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain and function 1 | Shoulder Pain and Disability Index | Baseline | 
| Pain and function 2 | Shoulder Pain and Disability Index | At 6 weeks | 
| Pain and function 3 | Shoulder Pain and Disability Index | At 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fear avoidance 1 | Fear-Avoidance Beliefs Questionnaire. Modified version with questions about shoulder instead of back | Baseline | 
| Fear avoidance 2 | Fear-Avoidance Beliefs Questionnaire. Modified version with questions about shoulder instead of back. | At 6 weeks | 
| Quality of life 1 | The Short-Form 36 questionnaire | Baseline | 
| Quality of life 2 | The Short-Form 36 questionnaire | At 6 weeks | 
| Pain the last week | Numeric pain rating scale | Baseline and once a week for 6 weeks | 
| Active range of motion 1 | Abduction, flexion, external rotation and internal rotation measured with inclinometer | Baseline | 
| Active range of motion 2 | Abduction, flexion, external rotation and internal rotation measured with inclinometer | At 6 weeks | 
| Impingement tests 1 | Hawkins test, painful arc test and isometric external rotation test is beeing conducted and scored positive or negative | Baseline | 
| Impingement tests 2 | Hawkins test, painful arc test and isometric external rotation test is beeing conducted and scored positive or negative | At 6 weeks | 
| Work status 1 | Registration of the patients work status | Baseline | 
| Work status 2 | Registration of the patients work status | At 6 weeks | 
| Work status 3 | Registration of the patients work status | At 6 months | 
| Patient satisfaction | 2 questions, one question about benefit and one about satisfaction | At 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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shoulder pain, shoulder impingement, rotatorcuff pathology, supervised exercise, homebased exercise