Effectiveness of Occupation-Based Intervention Compared With Therapeutic Exercise for Older Adults With Shoulder OA.

Study Overview
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Brief Summary
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As a registered and licensed occupational therapist, I completed a six-week evidence based research study to determine the effects of occupation-based intervention and therapeutic exercises versus therapeutic exercises alone.

Detailed Description
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Importance: There is a need for evidence to support occupation-based intervention (OBI) for older adults with shoulder osteoarthritis (OA). Objective: To evaluate the effectiveness of OBI on function in older adults with shoulder OA compared to therapeutic exercise (TE). Design: Randomized controlled trial. Six-week intervention. 1-week and 4-week follow-up. Setting: Outpatient clinic. Participants: Ten older adults with diagnosis of shoulder OA via convenience sampling. Intervention: Participants were seen two times/week for six weeks. The OBI group completed 30 minutes of TE followed by 30 minutes of OBI. The TE group completed 60 minutes of TE. Outcome and Measures: Functional outcomes were assessed at pre-, 1-week post, and 4-weeks posttreatment using the QuickDASH as the primary outcome measure.

Official Title
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Effectiveness of an Occupation-Based Intervention Compared With Therapeutic Exercise for Older Adults With Shoulder Osteoarthritis: A Pilot Randomized Controlled Trial

Conditions
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Osteoarthritis Shoulder

Intervention / Treatment
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* Procedure: Therapeutic Exercise
* Procedure: Occupation-Based Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of shoulder osteoarthritis (confirmed by physician examination or radiographic imaging) Aged 65 years or older Exclusion Criteria: Previous shoulder injuries Acute pathology Previous shoulder surgery Current use of pain medication Inflammatory arthritis Upper extremity neuropathy or myopathy Current participation in a home exercise program Score of <18 on the Mini-Mental State Examination (MMSE)

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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
Interventional Model Description: Randomized Controlled Trial
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Occupation-Based Intervention + Therapeutic Exercise Intervention Group<br>Sixty-minute occupational therapy sessions were completed two times a week for six weeks consisting of 30 minutes therapeutic exercise followed by 30 minutes of occupation-based intervention. | Procedure: Therapeutic Exercise<br>* Passive range of motion (PROM), active-assistive range of motion (AAROM), active range of motion (AROM), and strengthening activities.<br>Procedure: Occupation-Based Intervention<br>* Collecting and placing items in cabinets, washing windows and tables, and hanging clothes on a clothesline.<br>|
| Experimental: Therapeutic Exercise Control Group<br>Sixty-minute occupational therapy sessions were completed two times a week for six weeks consisting of therapeutic exercise only. | Procedure: Therapeutic Exercise<br>* Passive range of motion (PROM), active-assistive range of motion (AAROM), active range of motion (AROM), and strengthening activities.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) Baseline scores | To assess the impact of the intervention on physical function and symptoms of shoulder osteoarthritis. Minimum Value: 0 (no disability) Maximum Value: 100 (most severe disability) Higher scores = Worse outcome (greater upper extremity dysfunction) | Pre-Intervention | 
| Change between Pre-Intervention and 1-week Post-Intervention Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores | To assess the impact of the intervention on physical function and symptoms of shoulder osteoarthritis. Minimum Value: 0 (no disability) Maximum Value: 100 (most severe disability) Higher scores = Worse outcome (greater upper extremity dysfunction) | 1-week Post-Intervention | 
| Change between Pre-Intervention and 4-weeks Post-Intervention Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores | To assess the impact of the intervention on physical function and symptoms of shoulder osteoarthritis. Minimum Value: 0 (no disability) Maximum Value: 100 (most severe disability) Higher scores = Worse outcome (greater upper extremity dysfunction) | 4-weeks Post-Intervention | 
| Change between 1-week and 4-weeks Post-Intervention Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores | To assess the impact of the intervention on physical function and symptoms of shoulder osteoarthritis. Minimum Value: 0 (no disability) Maximum Value: 100 (most severe disability) Higher scores = Worse outcome (greater upper extremity dysfunction) | 4-weeks Post-Intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Canadian Occupational Performance Measure (COPM) Baseline Scores | To determine the effect of the intervention on participants' self-perception of occupational performance and satisfaction over time. Minimum Value: 0 Maximum Value: 10 Higher scores = Better outcome (greater client-perceived changes in satisfaction and performance of daily occupations) | Pre-Intervention | 
| Change between Pre-Intervention and 1-week Post-Intervention Canadian Occupational Performance Measure (COPM) scores | To determine the effect of the intervention on participants' self-perception of occupational performance and satisfaction over time. Minimum Value: 0 Maximum Value: 10 Higher scores = Better outcome (greater client-perceived changes in satisfaction and performance of daily occupations) | 1-week Post-Intervention | 
| Change between Pre-Intervention and 4-weeks Post-Intervention Canadian Occupational Performance Measure (COPM) scores | To determine the effect of the intervention on participants' self-perception of occupational performance and satisfaction over time. Minimum Value: 0 Maximum Value: 10 Higher scores = Better outcome (greater client-perceived changes in satisfaction and performance of daily occupations) | 4-weeks Post-Intervention | 
| Change between 1-week and 4-weeks Post-Intervention Canadian Occupational Performance Measure (COPM) scores | To determine the effect of the intervention on participants' self-perception of occupational performance and satisfaction over time. Minimum Value: 0 Maximum Value: 10 Higher scores = Better outcome (greater client-perceived changes in satisfaction and performance of daily occupations) | 4-weeks Post-Intervention | 
| Shoulder Range of Motion (ROM) Baseline Scores | Observing and grading ROM on a 3-point Likert scale to determine shoulder mobility and pain with movement. Minimum Value: 0 (unable/no pain) Maximum Value: 3 (full able/lots of pain) Higher scores = Better outcome (fully ROM/no pain with ROM) | Pre-Intervention | 
| Change between Pre-Intervention and 1-week Shoulder Range of Motion (ROM) scores | Observing and grading ROM on a 3-point Likert scale to determine shoulder mobility and pain with movement. Minimum Value: 0 (unable/no pain) Maximum Value: 3 (fully able/lots of pain) Higher scores = Better outcome (full ROM/no pain with ROM) | 1-week Post-Intervention | 
| Change between Pre-Intervention and 4-weeks Post-Intervention Shoulder Range of Motion (ROM) scores | Observing and grading ROM on a 3-point Likert scale to determine shoulder mobility and pain with movement. Minimum Value: 0 (unable/no pain) Maximum Value: 3 (fully able/lots of pain) Higher scores = Better outcome (full ROM/no pain with ROM) | 4-weeks Post-Intervention | 
| Change between 1-week and 4-weeks Post-Intervention Shoulder Range of Motion (ROM) scores | Observing and grading ROM on a 3-point Likert scale to determine shoulder mobility and pain with movement. Minimum Value: 0 (unable/no pain) Maximum Value: 3 (fully able/lots of pain) Higher scores = Better outcome (full ROM/no pain with ROM) | 4-weeks Post-Intervention | 
| Jamar Hand Dynamometer Baseline Scores | To measure grip strength. Minimum Value: 0 pounds Maximum Value: 200 pounds Higher scores = Better outcome (increased grip strength) | Pre-Intervention | 
| Change between Pre-Intervention and 1-week Jamar Hand Dynamometer scores | To measure grip strength. Minimum Value: 0 pounds Maximum Value: 200 pounds Higher scores = Better outcome (increased grip strength) | 1-week Post-Intervention | 
| Change between Pre-Intervention and 4-weeks Post-Intervention Jamar Hand Dynamometer scores | To measure grip strength. Minimum Value: 0 pounds Maximum Value: 200 pounds Higher scores = Better outcome (increased grip strength) | 4-weeks Post-Intervention | 
| Change between 1-week and 4-weeks Post-Intervention Jamar Hand Dynamometer Scores | To measure grip strength. Minimum Value: 0 pounds Maximum Value: 200 pounds Higher scores = Better outcome (increased grip strength) | 4-weeks Post-Intervention | 
| Numeric Pain Rating Scale (NPRS) Baseline Scores | To measure pain. Minimum Value: 0 (no pain) Maximum Value: 10 (worst possible pain) Higher scores = Worse outcome (increased pain) | Pre-Intervention | 
| Change between Pre-Intervention and 1-week Numeric Pain Rating Scale (NPRS) Scores | To measure pain. Minimum Value: 0 (no pain) Maximum Value: 10 (worst possible pain) Higher scores = Worse outcome (increased pain) | 1-week Post-Intervention | 
| Change between Pre-Intervention and 4-weeks Post-Intervention Numeric Pain Rating Scale (NPRS) Scores | To measure pain. Minimum Value: 0 (no pain) Maximum Value: 10 (worst possible pain) Higher scores = Worse outcome (increased pain) | 4-weeks Post-Intervention | 
| Change between 1-week and 4-weeks Post-Intervention Numeric Pain Rating Scale (NPRS) scores | To measure pain. Minimum Value: 0 (no pain) Maximum Value: 10 (worst possible pain) Higher scores = Worse outcome (increased pain) | 4-weeks Post-Intervention |