Clinical trial NCT06752551: Apprehension-based Training Compared With Standard Physical Therapy for Military Personnel Following Anterior Shoulder Dislocation - a Randomized Clinical Trial
Official title: Apprehension-based Training Compared With Standard Physical Therapy Among Military Personnel Following Anterior Shoulder Dislocation
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Anterior Shoulder Dislocation
Keywords: Randomized clinical trial
Anterior shoulder dislocation
Shoulder instability
Physical therapy
Lead sponsor: Ariel University
Sponsor class: OTHER
Collaborators: name: Medical Corps, Israel Defense Force
First posted: 2024-12-30
Enrollment: 85
Sex: ALL
Minimum age (years): 18
Maximum age (years): 39
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Randomized controlled trial:

Study intervention: apprehension-based training Control intervention: standard physical therapy
Primary purpose: TREATMENT

Brief summary: The goal of this clinical trial is to determine if a new rehabilitation protocol (apprehension-based training), leads to better recovery after shoulder dislocation among military personnel.

Participants will be randomly allocated to apprehension-based training or standard physical therapy. In apprehension-based training participants will train to control their shoulder under progressively more unstable conditions. Standard physical therapy will be provided based on the clinical judgment of the treating physical therapist The primary hypothesis is that participants undergoing apprehension-based training will experience a more complete recovery of function, better shoulder-related quality of life, and incur less recurrent dislocations.


Eligibility criteria: Inclusion Criteria:

* Age 18-39 years
* Shoulder dislocation (primary or recurrent) documented by a medical practitioner (physician, military medic)
* Positive anterior apprehension test
* Gross shoulder muscle strength 3/5 or greater

Exclusion Criteria:

* Previous shoulder fracture, tendon tear, or shoulder surgery
* Voluntary shoulder dislocation
* Functional (Stanmore polar III) shoulder instability
* Dislocation associated with a motor vehicle accident.
* Diagnosis of rheumatoid arthritis, cancer (current), fibromyalgia, psychiatric disease)
* Current pregnancy
* Inability to attend at least one physical therapy session every 2 weeks.

Primary outcomes:
measure: Return to preinjury level of function
timeFrame: 3 months following the end of intervention
measure: Western Ontario Shoulder Instability Index
timeFrame: Baseline to end of intervention (10 weeks) and 1-year follow-up (62 weeks).
measure: Recurrence
timeFrame: One year following the end of the intervention
measure: Supine moving apprehension test
timeFrame: Baseline to end of intervention (10 weeks)
Secondary outcomes:
measure: Subjective shoulder value
timeFrame: Baseline, end of intervention (10 weeks), and 1-year follow up (62 weeks)
measure: Tampa scale of kinesiophobia
timeFrame: Baseline, end of intervention (10 weeks), and 1-year follow-up (62 weeks)
measure: Anterior apprehension test
timeFrame: Baseline to end of intervention (10 weeks)
measure: Shoulder internal/external rotator muscle strength
timeFrame: Baseline and end of intervention (10 weeks)
measure: Abdominal rollout
timeFrame: Baseline and end of intervention (10 weeks)
measure: Heart rate variability
timeFrame: Baseline and end of intervention (10 weeks).
Other outcomes:
Locations:
city: Be'er Ya'akov
country: Israel
facility: Israel Defense Forces Medical Corps
Study officials:
affiliation: Ariel University
name: Alon Rabin, PhD, DPT
role: STUDY_CHAIR
References:
citation: Rabin A, Noyman L, Yaakobi N, Kazum E. Apprehension-Based Training: A Novel Treatment Concept for Anterior Shoulder Dislocation - A Case Report. Int J Sports Phys Ther. 2024 Jul 1;19(7):888-897. doi: 10.26603/001c.118928. eCollection 2024.
citation: Rabin A, Chechik O, Olds MK, Uhl TL, Kazum E, Deutsch A, Citron E, Cohen T, Dolkart O, Bibas A, Maman E. The supine moving apprehension test-Reliability and validity among healthy individuals and patients with anterior shoulder instability. Shoulder Elbow. 2024 Feb;16(1):98-105. doi: 10.1177/17585732231170197. Epub 2023 Apr 18.