Ambulatory Rehabilitation Program in Patients With Degenerative Rupture of the Rotator Cuff Tendons of the Shoulder

Study Overview
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Brief Summary
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The main objective of the research is to study the effectiveness of an ambulatory rehabilitation program based on mobilization and muscular solicitation, during painful shoulders by full-thickness degenerative rupture of the tendons of the rotator cuff. , with the algo-functional state, ie pain and activity limitation, as judgment criteria, at 3 months.

Detailed Description
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Our hypothesis is that rehabilitation based on mobilization and muscular solicitation is effective in painful shoulder due to degenerative rupture of the tendons of the rotator cuff; that it reduces pain, functional limitation and the need for surgery. Research Excluding health products: Experimental group: Ambulatory rehabilitation program based on mobilization and muscular solicitation Control group: Ambulatory rehabilitation program using of ultrasound physiotherapy

Official Title
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Efficiency of an Ambulatory Rehabilitation Program in Patients With Shoulder Degenerative Rupture of the Rotator Cuff Tendons

Conditions
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Shoulder Pain

Intervention / Treatment
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* Procedure: Ambulatory rehabilitation program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 55 years old, Painful shoulder for at least 1 month, Shoulder treated with at least one cortisone infiltration one month or more before inclusion, Pain ≥ 40/100 on visual analog scale, Pain reproduced by at least one clinical test of rotator cuff tendons or subacromial impingement (Jobe, Patte, Neer, Yocum test, Hawkins), Full-thickness tear of at least one tendon of the rotator cuff attested by imaging, Affiliation to social security Exclusion Criteria: Passive glenohumeral mobility of the shoulder limited, Calcifying tendinopathy on standard radiography, Glenohumeral arthropathy; Painful acromioclavicular arthropathy; History of shoulder fracture; Neurogenic pain or neurogenic motor deficit of the upper limb; Cortisone infiltration of the shoulder in the month preceding inclusion; Operated shoulder; Systemic pathologies including inflammatory rheumatism or neoplastic pathology; Patient participating in another experimental research; Patient under legal protection (curators or guardianship) Patient deprived of liberty by a judicial or administrative decision Pregnant or breastfeeding woman

Ages Eligible for Study
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Minimum Age: 55 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: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Experimental group: Ambulatory rehabilitation program based on mobilizations and muscular solicitations (muscle strengthening and dynamic humeral recentering), supervised by a physiotherapist, consisting of 15 individual sessions of 30 minutes each, spread over 8 weeks, according to a standardized program . Control group: Ambulatoryrehabilitation program, consisting of ultrasound physiotherapy, supervised by a physiotherapist, consisting of 15 individual sessions of 30 minutes each, spread over 8 weeks.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental Group<br>Ambulatory rehabilitation program based on mobilization and muscular solicitation | Procedure: Ambulatory rehabilitation program<br>* Experimental group: Ambulatory rehabilitation program based on mobilization and muscular solicitation.<br>|
| Active Comparator: Control Group<br>Ambulatory rehabilitation program using ultrasound physiotherapy | Procedure: Ambulatory rehabilitation program<br>* Experimental group: Ambulatory rehabilitation program based on mobilization and muscular solicitation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Shoulder Pain | algo-functional scorec SPADI, measured with Visual Analog Score | At 3 month follow-up | 
| Shoulder disability | algo-functional score SPADI, measured with Visual Analog Score | At 3 month follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Shoulder active mobility | Pain subscore of the SPADI scale Abduction strength by dynamometer, Activity limitation by the function subscore of the SPADI scale , Life quality Overall improvement perceived by the patient by the 5-point Likert scale, at 3 months, 6 months and 1 year; The total algo-functional score of the SPADI scale at 6 months and 1 year; The use of non-surgical care, Assessed by drug consumption, the number of cortisone infiltrations, The number of non-protocol rehabilitation sessions and the number of consultations outside the scope of the study; The use of surgery for degenerative rupture of the tendons of the rotator cuff by the number of surgical interventions and the Type of surgery performed in this indication during follow-up, The time off work by the number of days | 3, 6, 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Shoulder Pain, rotator cuff tendons, Ambulatory rehabilitation