Efficacy of mobilization with movement versus wait-and-see for patients with subacromial shoulder pain: a pilot randomized controlled trial

• Grant number: 22/08296-5
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate (Direct)
• Effective date (Start): February 01, 2023
• Effective date (End): January 31, 2024
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Paula Rezende Camargo
• Grantee: Vander Gava
• Supervisor: Daniel Cury Ribeiro
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
• Research place: University of Otago, New Zealand
• Associated to the scholarship: 20/01449-5 - Web-based instrument intervention for individuals with shoulder pain: randomized clinical trial, BP.DD

Abstract

Shoulder pain is a common musculoskeletal condition, affecting one third of the world population. The conservative treatment is the first-line intervention, with mobilization with movement being a commonly used intervention in the clinical setting. However, evidence on the effects of mobilization with movement are lacking in the literature. Previous laboratory-based studies have shown that: (1) clinician-administrated sustained shoulder posterolateral glide mobilization offloads shoulder muscles, providing mechanical support to the shoulder; (2) self-administrated sustained shoulder mobilizations lead to similar changes in muscle activity level as clinician-administrated mobilization, supporting the use of home-based mobilization for shoulder rehabilitation; (3) patients with shoulder pain present immediate reduction in pain levels, increased range of motion, and increased muscle activity levels in response to mobilization with movement. Those findings suggest that sustained mobilization temporarily changes the control of scapular and shoulder muscles in asymptomatic and individuals with subacromial shoulder pain. Objective: The present proposal aims to advance the current knowledge further by piloting the design of a full trial to test the effectiveness of mobilization with movement on the management of patients with shoulder subacromial pain. Methods: This study is a prospective, assessor-blind, parallel-group randomized controlled pilot trial. A total sample size of 24 participants with subacromial shoulder pain will be allocated to mobilization with movement group or wait-and-see group. Patients in the mobilization with movement group will receive a tailored mobilization with movement technique over 8 weeks, with two treatment sessions per week. Primary outcomes will be participant's recruitment rate; proportion of participants enrolled from the total number screened; adherence to the allocated intervention; drop-out rate, and treatment fidelity. Participants will be assessed 4 times over 12 weeks (baseline, 4, 8, and 12 weeks). An intention-to-treat analysis approach will be applied for all analyses. Primary outcomes will be presented using descriptive statistics. An independent mixed-model will be conducted for each outcome measure. An implementation-based process evaluation will be assessed by interviewing participants who take part in the study with a thematic qualitative analysis. (AU)