6533b859fe1ef96bd12b82dd
RESEARCH PRODUCT
A central nervous system-focused treatment approach for people with frozen shoulder: protocol for a randomized clinical trial
Lirios DueñasSilvia Mena-del HornoAdriaan LouwSantiago Navarro-ledesmaEnrique Lluch-girbésAlejandro Luque-suarezsubject
Time FactorsJoint mobilizationDolor de hombro:Phenomena and Processes::Physical Phenomena::Time::Time Factors [Medical Subject Headings]Shoulder painShoulder adhesive capsulitisPsychological interventionMedicine (miscellaneous)law.invention:Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings]Disability EvaluationStudy ProtocolDiscrimination Psychological0302 clinical medicineRandomized controlled trialFeedback Sensorylaw:Analytical Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Physical Therapy Modalities [Medical Subject Headings]:Diseases::Musculoskeletal Diseases::Joint Diseases::Bursitis [Medical Subject Headings]Pharmacology (medical)030212 general & internal medicineRange of Motion ArticularPhysiotherapyFisioterapiaRandomized Controlled Trials as Topic:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Clinical Trials as Topic::Controlled Clinical Trials as Topic::Randomized Controlled Trials as Topic [Medical Subject Headings]lcsh:R5-920Shoulder JointFrozen shoulder:Analytical Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Disability Evaluation [Medical Subject Headings]Treatment OutcomeCohortlcsh:Medicine (General):Anatomy::Musculoskeletal System::Skeleton::Joints::Shoulder Joint [Medical Subject Headings]medicine.medical_specialtyBlindingSensationContext (language use)03 medical and health sciencesBursitismedicineHumansPhysical Therapy Modalities:Analytical Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings]:Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings]:Anatomy::Nervous System::Central Nervous System [Medical Subject Headings]business.industry:Analytical Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Range of Motion Articular [Medical Subject Headings]Recovery of FunctionCapsulitismedicine.disease:Phenomena and Processes::Biological Phenomena::Recovery of Function [Medical Subject Headings]Sistema nervioso central:Phenomena and Processes::Musculoskeletal and Neural Physiological Phenomena::Nervous System Physiological Phenomena::Nervous System Physiological Processes::Sensation [Medical Subject Headings]SpainCentral nervous systemOrthopedic surgeryShoulder adhesivePhysical therapy:Phenomena and Processes::Physiological Phenomena::Physiological Processes::Homeostasis::Feedback Physiological::Feedback Sensory [Medical Subject Headings]business030217 neurology & neurosurgerydescription
Background: Frozen shoulder (FS) is a musculoskeletal condition of poorly understood etiology that results in shoulder pain and large mobility deficits. Despite some physical therapy interventions, such as joint mobilization and exercise, having shown therapeutic benefit, a definitive treatment does not currently exist. The aim of this study will be to compare the effectiveness of a central nervous system (CNS)-directed treatment program versus a standard medical and physical therapy care program on outcomes in participants with FS. Methods/design: The study is a two-group, randomized clinical trial with blinding of participants and assessors. Participants will be recruited via referrals from orthopedic surgeons and physical therapists, community-based advertisements, private care practices and hospitals. Participants will be randomized to receive either a CNS-focused treatment program or standard medical and physical therapy care. The Shoulder Pain And Disability Index (SPADI) will be the primary outcome, while the Numeric Pain Rating Scale (NPRS), shoulder range of movement (ROM), The Patient Specific Functional Scale, two-point discrimination threshold and laterality judgement accuracy will be the secondary outcomes. Assessment will occur at baseline, at the end of the treatment program (week 10), and at 3 and 6 months’ follow-up. Discussion: Preliminary data suggest that treatments that target CNS function are a promising approach to the treatment of people with shoulder pain including patients with FS. In the context of modest effects from most available physical therapy treatments for FS, this CNS-focused approach may lead to improved clinical outcomes. The trial should determine if the CNS-directed program is more effective than traditional interventions at reducing pain intensity and improving function in a FS cohort and will follow up participants for 6 months, providing important information on the persistence of any treatment effects.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-08-13 |