The Effect of an Evidence-based Physiotherapy Regimen for Patients With Rotator Cuff Tendinopathy

Launched by BERGEN UNIVERSITY COLLEGE · Nov 26, 2014

Keywords

ClinConnect Summary

There has been a fourfold increase in surgery rates for non-traumatic shoulder disorders , despite increasing evidence demonstrating that there is no difference in effect between physiotherapy based- and surgical interventions. The target population for this study is patients suffering from rotator cuff tendinopathy waiting for subacromial decompression surgery at a university hospital in Norway. During this waiting period , study participants will be randomly assigned to standard follow up or a physiotherapy regimen in primary care. We want to compare the effect of a structured physiothera...

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Eligibility criteria

• Inclusion Criteria:
• • Patients on need for surgery ( placed at surgical waiting list at hospital or referred to surgery by their GP )
• • 1. Typical history with difficulties working with arms elevated over the head, and pain located in the upper segment of C5 dermatome.
• • 2. Symptom duration of minimum 3 months.
• 3. Three or more reproducible signs of rotator cuff tendinopathy / subacromial impingement:
• • Positive isometric abduction and/or lateral rotation (Ombregt, Bisschop \& Veer, 2003)
• • Painful arc during active abduction (Ombregt, Bisschop \& Veer, 2003)
• • Positive Neers sign (Neer, 1972 ; Tennent, Beach \& Meyers, 2003)
• • Positive Jobes test (Jobe \& Moynes, 1982 ; Tennent, Beach \& Meyers, 2003)
• • Positive Hawkins-Kennedy impingement test (Hawkins \& Kennedy, 1980)
• Exclusion Criteria:
• • 1. Shoulder pain due to trauma, e.g. fall.
• • 2. Reduced ROM consistent with adhesive capsulitis/frozen shoulder
• • 3. History in combination with examination and tests (apprehension/relocation), giving reason to suspect pathological instability
• • 4. Full thickness rupture of rotator cuff tendon
• • 5. OA of the glenohumeral joint, Os acromiale with decreased space of the subacromial space, previous fractures in the shoulder complex or shoulder surgery on the symptomatic side.
• • 6. Subjects with other comorbidity: Rheumatological or neurological disease, fibromyalgia or symptoms from the cervical spine
• • 7. Subjects suffering from serious psychiatric illness.
• • 8. Subjects unable to understand English or Norwegian.
• • 9. Less than 3 positive reproducible sings of rotator cuff pathology / subacromial disease.