Investigation The Efficacy of Manual Therapy and Exercise in Patients With Glenohumeral Arthritis

Study Overview
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Brief Summary
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The aim of the investigator's study is to compare the efficacy of manual therapy and exercise practices compared to exercise practice in patients with Glenohumeral Arthritis. Thirty volunteer patients will include into the study.

Detailed Description
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Patients will randomly divide into two groups. A common exercise program was applied to both groups during 15 sessions. Manual therapy techniques will apply to the manual therapy group in addition to exercise practices. Patients will evaluate in terms of functional status, pain, range of motion, muscle strength and health-related quality before and after 5 weeks of treatment. Also, patient's satisfaction from treatment will evaluate at the 5th week of the treatment. DASH and ASES forms for functional status, VAS for pain, digital goniometer for range of motion, manual muscle test for muscle strength, SF-12 for health-related quality of life, and Global Rating of Change (GRC) Scale for patient satisfaction will be used as evaluation criteria.

Official Title
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Istanbul University, Faculty of Health Science, Division of Physiotherapy and Rehabilitation

Conditions
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Glenohumeral Arthritis

Intervention / Treatment
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* Other: Manuel Therapy plus Exercise Intervention
* Other: Exercise Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 40 years and older patients To be diagnosed with GHOA by specialist physician via MRI, US or radiography and physical examination Unilateral shoulder pain lasting more than 2 months seen during daily living activities and at rest Exclusion Criteria: Patients with: Severe arthrosis Tumor Cervical radiculopathy Emotional or cognitive problems A neurological disease that causes muscle weakness on the shoulder A skin disease that may affect upper extremity assessment. Frozen shoulder Thoracic outlet syndrome

Ages Eligible for Study
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Minimum Age: 40 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ''Manuel Therapy group''<br>This treatment group will be received Manuel Therapy techniques and exercise interventions. | Other: Manuel Therapy plus Exercise Intervention<br>* Shoulder mobilization techniques include glenohumeral traction, anterior, posterior and inferior glide. We will also use anterior, posterior and inferior joint stretching exercises and scapular mobilization. Exercise interventions include range of motion exercises, stretching exercises, strengthening exercises, and pendulum exercises.<br>|
| Experimental: ''Exercise group''<br>This treatment group will be received only exercise interventions. | Other: Exercise Intervention<br>* Exercise interventions include range of motion exercises, stretching exercises, strengthening exercises, and pendulum exercises.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Shoulder Range of Motion (ROM) | The shoulder flexion, abduction, internal and external rotation ROM will be evaluated with digital goniometer while the patient will be in supine position. | Evaluation will be performed first time at baseline and second time will be performed after 5 weeks rehabilitation program. After treatment change will be assessed. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ASES (The American Shoulder and Elbow Surgeons Standardized Shoulder Assessment) Form | ASES is an assessment form prepared by shoulder and elbow surgeons with objective and subjective sections. The total score is at least 0 and at most 100, and the high scores are positively correlated with the normal function. | Evaluation will be performed before treatment and after 5 weeks rehabilitation program. | 
| Visual Analogue Scale (VAS) | The levels of pain is felted at rest / activity / night will be measured using Visual Analogue Scale (VAS).Patients will be asked to evaluate their pain status with a 10-point scale and high scores are positively correlated with pain. | Evaluation will be performed before treatment and after 5 weeks rehabilitation program. | 
| Manual Muscle Test | Manual Muscle Test is a procedure for the evaluation of strength of individual muscle or muscles group, based upon the effective performance of a movement in relation to the forces of gravity or manual resistance through the available ROM. | Evaluation will be performed before treatment and after 5 weeks rehabilitation program. | 
| Short Form 12 (SF-12) | SF-12 will be used to assess physical and mental health-related quality of life. The total score is at least 0 and at most 100, and the high scores are positively correlated with high quality of life. | Evaluation will be performed before treatment and after 5 weeks rehabilitation program. | 
| Global Rating of Change (GRC) Scale | Global Rating of Change (GRC) scale will be used to assess the overall satisfaction levels of the patients. Patients will be asked to evaluate their post-treatment status with a 5-point likert scale and high scores are positively correlated with satisfaction. | Evaluation will be performed after 5 weeks rehabilitation program. | 
| The Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire | DASH questionnaire inquires about the activities of a person in daily life, the degree of participation in recreational activities, the symptom and psychosocial state that affects their pain, emotional state and sleep quality. The total score is at least 0 and at most 100, and the high scores are positively correlated with the increased functional impairment. | Evaluation will be performed before treatment and after 5 weeks rehabilitation program. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Glenohumeral Arthritis, Pain, Mobilisation, Physiotherapy, Rehabilitation