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高容量动员与运动对肩袖相关肩痛患者肩部活动度和疼痛的初始影响:一项随机对照试验方案(Evolution 试验)。

Initial effect of high-volume mobilisation with movement on shoulder range of motion and pain in patients with rotator cuff-related shoulder pain: protocol for a randomised controlled trial (Evolution Trial).

机构信息

Centre for Health, Activity and Rehabilitation Research (CHARR) - School of Physiotherapy, University of Otago, Dunedin, New Zealand.

Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.

出版信息

BMJ Open. 2023 Aug 9;13(8):e069919. doi: 10.1136/bmjopen-2022-069919.

Abstract

INTRODUCTION

Mobilisation with movement (MWM) is commonly used for treating patients with rotator cuff-related shoulder pain (RCRSP). However, the evidence supporting MWM efficacy for improving shoulder range of motion (ROM) and pain in patients with RCRSP is limited. It is also unclear whether higher volume MWM leads to better clinical outcomes compared with lower volume MWM in patients with RCRSP. The primary aim of this study is to assess the effect of MWM on the angular onset of pain during shoulder abduction in patients with RCRSP.

METHODS AND ANALYSIS

Sixty participants with RCRSP will be randomised to receive either MWM or sham MWM intervention. The primary outcome is the angular onset of pain during shoulder abduction, and secondary outcomes are pain intensity at the angular onset of pain during shoulder abduction, maximum shoulder ROM, pain intensity during maximum shoulder abduction, pressure pain threshold, mechanical temporal summation, global rating of change scale (GROC) and Brief Pain Inventory-Short Form (BPI-SF). The angular onset of pain and the pain intensity at that range will be assessed at baseline, after 1 set and 3 sets of 10 repetitions of MWM or sham MWM. The GROC will be measured immediately after receiving 3 sets of interventions and on day 3 after interventions. The BPI-SF will be measured on days 1, 3, 5 and 7 after interventions. Other secondary outcomes will be assessed at baseline and after 3 sets of interventions. A linear mixed effects model with a random intercept will be used to compare changes in the outcome measures between MWM and sham MWM interventions.

ETHICS AND DISSEMINATION

This study has been approved by the University of Otago Ethics Committee (Ref. H21/117). Findings from this study will be disseminated through presentations at international and national conferences and will be submitted for publication in a peer-reviewed journal.

TRIAL REGISTRATION NUMBER

ACTRN 12621001723875.

摘要

简介

运动松动术(MWM)常用于治疗肩袖相关肩痛(RCRSP)患者。然而,支持 MWM 对改善 RCRSP 患者肩部活动范围(ROM)和疼痛疗效的证据有限。目前尚不清楚在 RCRSP 患者中,更高频率的 MWM 是否比低频率 MWM 能带来更好的临床效果。本研究的主要目的是评估 MWM 对 RCRSP 患者肩外展起始时疼痛角度的影响。

方法和分析

将 60 名 RCRSP 患者随机分为 MWM 或假 MWM 干预组。主要结局是肩外展起始时的疼痛角度,次要结局是肩外展起始时疼痛的疼痛强度、最大肩部 ROM、最大肩部外展时的疼痛强度、压力疼痛阈值、机械时间总和、整体变化量表(GROC)和简明疼痛量表(BPI-SF)。在基线、MWM 或假 MWM 治疗 1 组和 3 组 10 次重复后,评估疼痛角度和该范围内的疼痛强度。GROC 将在接受 3 组干预后立即测量,在干预后第 3 天测量。BPI-SF 将在干预后第 1、3、5 和 7 天测量。其他次要结局将在基线和 3 组干预后评估。采用随机截距线性混合效应模型比较 MWM 和假 MWM 干预之间结局指标的变化。

伦理与传播

本研究已获得奥塔哥大学伦理委员会的批准(参考号:H21/117)。本研究的结果将通过在国际和国内会议上的报告进行传播,并将提交给同行评议期刊发表。

试验注册号

ACTRN 12621001723875。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c50/10414061/4829c452f7fc/bmjopen-2022-069919f01.jpg

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