Clinical trial NCT05524870: The Effect of Manual Therapy on Central Sensitization
Official title: Movement With Mobilization Technic Plus Exercising Versus Exercising Alone for Central Sensitization in Patients With Subacromial Pain: a Sham-controlled Randomized Clinical Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Subacromial Pain Syndrome
Central Sensitisation
Keywords: Manual therapy
Shoulder pain
Mobilization
Lead sponsor: Cukurova University
Sponsor class: OTHER
First posted: 2022-09-01
Enrollment: 63
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Subacromial pain syndrome (SIS) is a common cause of shoulder pain, estimated to be the cause for up to half of incident cases. Typically, pain is generated with elevation of the arm above the head though it can occur with rest in patients with SIS.There is evidence of central sensitization in those who experience chronic shoulder pain from SIS. Central sensitization is an augmentation of the nociceptive pathways of the central nervous system that is characterized by local and generalized lowered pain thresholds and an exaggerated pain response to painful and non painful stimulation.Mobilization with movement (MWM) technic is a kind of manual therapy and it is often used by clinicians for the treatment of musculoskeletal diseases. Usually manual therapy is used for its peripheral effects, however it also produces central analgesic effects activating descending anti-nociceptive pathways for a short period of time (30 - 35 mins.). Some speculate that repeated sessions of manual therapy may result in a long term activation of descending anti-nociceptive pathways. However, there is no evidence of this mechanism available yet. Therefore, the aim of this study is to investigate the effect of MWM on central sensitization (primary aim) and shoulder functions (secondary aim) in patients with SIS.


Eligibility criteria: Inclusion Criteria:

* To have confirmed unilateral subacromial pain (positive testing at Neer Impingement and Hawkins-Kennedy tests),
* To have \<40 score in central sensitization inventory.

Exclusion Criteria:

* To have bilateral subacromial pain,
* To have any pathology (except subacromial pain) that give rise to central sensitization (This pathologies are summarized in central sensitization inventory - part B)
* To have severe osteoarthritis or subluxation in shoulder joint,
* To have adhesive capsulitis,
* Being treated with physiotherapy for this disorder at least one month before the start of the study.
* To have severe cervical or lumbar radiculopathy,

Primary outcomes:
measure: Central Sensitization Inventory
timeFrame: Baseline, 3 weeks: change from baseline central sensitization at 3 weeks, 3 months: change from central sensitization at 3 months.
measure: Pressure-Pain Threshold-Algometer
timeFrame: Baseline, 3 weeks: change from baseline pressure pain threshold at 3 weeks, 3 months: change from pressure pain threshold at 3 months.
Secondary outcomes:
measure: Quick Disabilities of the Shoulder, Arm and Hand Questionnaire
timeFrame: Baseline, 3 weeks: change from baseline shoulder functions at 3 weeks, 3 months: change from shoulder functions at 3 months.
Other outcomes:
Locations:
city: Adana
country: Turkey
facility: Cukurova University
Study officials:
References: