A central nervous system-focused treatment approach for people with frozen shoulder: protocol for a randomized clinical trial
Metadatos
Afficher la notice complèteAuteur
Lluch Girbés, Enrique; Dueñas, Lirios; Mena del Horno, Silvia; Luque Suárez, Alejandro; Navarro Ledesma, Santiago; Louw, AdriaanEditorial
Springer Nature
Materia
Shoulder pain Shoulder adhesive capsulitis Central nervous system Physiotherapy
Date
2019Referencia bibliográfica
Lluch-Girbés, E., Dueñas, L., Mena-del Horno, S., Luque-Suarez, A., Navarro-Ledesma, S., & Louw, A. (2019). A central nervous system-focused treatment approach for people with frozen shoulder: protocol for a randomized clinical trial. Trials, 20(1), 498.
Patrocinador
This work is funded by the Conselleria de Educación, Investigación, Cultura y Deporte de la Generalitat Valenciana, Spain (GV/2016).Résumé
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.