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Passive mobilisation of shoulder region joints plus advice and exercise does not reduce pain and disability more than advice and exercise alone: a randomised trial |
Chen JF, Ginn KA, Herbert RD |
Australian Journal of Physiotherapy 2009;55(1):17-23 |
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* |
QUESTION: Is the addition of passive mobilisation of shoulder region joints to advice and exercise for patients with shoulder pain and stiffness more effective than advice and exercise alone? DESIGN: Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS: 90 people who had shoulder pain and stiffness for more than one month. INTERVENTION: All participants received advice and exercise. The experimental group also received passive joint mobilisation of shoulder region joints. OUTCOME MEASURES: Primary outcome measures included pain and disability measured with the 13-point Shoulder Pain and Disability Index. Secondary outcome measures were self-perceived global improvement measured on a 6-point scale and active ranges of motion. Subjects received a maximum of 10 sessions of therapy. Outcome measurements were taken at baseline, one month, and six months. RESULTS: The experimental group had 3% (95% CI -5 to 11) less pain and disability than the control group at one month and 1% (95% CI -13 to 16) less pain at six months, which are statistically nonsignificant. Their global perceived effect was 0.1 out of 5 (95% CI -0.2 to 0.4) worse than the control group at one month and 0.1 (95% CI -0.5 to 0.7) better at 6 months, which are also statistically non-significant. Differences between groups in all range of motion measures were small and statistically non-significant. CONCLUSION: The addition of passive joint mobilisation of shoulder region joints is not more effective than advice and exercise alone for shoulder pain and stiffness. TRIAL REGISTRATION: ACTRN 12605000080628.
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