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Effects on shoulder pain and disability of teaching patients with shoulder pain a home-based exercise program: a randomized controlled trial [with consumer summary]
Santello G, Rossi DM, Martins J, Libardoni TC, de Oliveira AS
Clinical Rehabilitation 2020 Jun 7:Epub ahead of print
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effect on shoulder pain and disability of teaching patients with shoulder pain how to undertake a home-based exercise program. DESIGN: A randomized controlled trial conducted from September 2015 to January 2016. SETTING: Participants' home. PARTICIPANTS: Sixty participants with shoulder pain who were waiting for physiotherapeutic treatment. INTERVENTIONS: The control group (n = 30) received minimal education about their shoulder condition and instructions to continue their activities as normal. The intervention group (n = 30) received a two-month home exercise program with one-hour sessions delivered by a physiotherapist to begin and one month after the program for exercise instructions. MAIN MEASURES: The primary outcome was change in the Shoulder Pain and Disability Index (SPADI). The secondary outcomes included change in the numeric pain rating scale and medication intake for pain relief. RESULTS: The patients' average age was 54.3 (13.8) years. SPADI scores at baseline were 60.9 (16.5) in the intervention and 64.7 (15.3) in the control group. After two months, the SPADI scores decreased to 18.8 (28.6) and to 61.4 (24.0), respectively, in the intervention and control groups with an estimated mean difference of 40.0, effect size: 1.61. The intervention group showed a reduced pain intensity (estimated mean difference 3.7, effect size 2.43) and medication intake (chi-square 0.001). The number needed to treat was 1.2 for one patient to have a SPADI score < 20. CONCLUSION: Teaching patients with shoulder pain how to undertake a home-based exercise program improved shoulder function and reduced pain intensity and medication intake over two months.

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