A Central Nervous System Focused Treatment Approach for Frozen Shoulder

NCT ID: NCT03320200

Last Updated: 2022-07-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-10-01

Study Completion Date

2021-02-18

Brief Summary

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The aim of this study is to compare the effectiveness of a CNS-directed treatment program versus a standard medical and physiotherapy care program on outcomes in participants with FS.Participants will be randomized to receive either a 10 weeks CNS-focused treatment program or standard medical and physiotherapy care.To evaluate the results of the interventions, the subjects will be assessed at the beginning, at the end of the treatment program (week 10) and at 3 and 6 months of follow-up.

Detailed Description

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The aim of this study is to compare the effectiveness of a CNS-directed treatment program versus a standard medical and physiotherapy care program on outcomes in participants with Frozen Shoulder (FS). It will consist of a randomized double-blind clinical trial (both participants and evaluators). The sample will consist of subjects with primary or idiopathic FS.

Once the sample is selected, participants will be randomly assigned to receive either a CNS-centered treatment program or a standard physiotherapy program. The CNS-centered treatment program will last for 10 weeks, conducted in 60-minute sessions on a weekly basis. In addition, participants in this group will complete a home treatment program for 30 minutes, five times a week. On the other hand, subjects assigned to the standard physiotherapy group will receive a 10-session treatment program, such as the CNS-centered treatment group. This standard treatment will include one corticosteroid infiltration provided in the early acute stage followed by a multimodal physiotherapy program including analgesic modalities (e.g. TENS, cryotherapy) and exercise and manual therapy techniques addressing the specific mobility deficits of each patient. Physiotherapists will be instructed not to include interventions that were similar to those used in the group receiving the CNS-focused protocol (e.g. using mirrors or imagined movements) and to include a home program that involves a training load comparable to that in the other group. Adherence to both interventions will be monitored using an individual treatment diary where the time of day and duration of each clinic and home session will be recorded To evaluate the results of the interventions, the subjects will be assessed at the beginning, at the end of the treatment program (week 10) and at 3 and 6 months of follow-up.

Conditions

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Adhesive Capsulitis of Shoulder Frozen Shoulder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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CNS-focused treatment

Group of subjects receiving a 10 week CNS (Central Nervous System) -focused treatment program for frozen shoulder in addition to 5 days per week home treatment program

Group Type EXPERIMENTAL

CNS-focused treatment

Intervention Type OTHER

The CNS-focused treatment will last for 10 weeks, conducted in 60-minute sessions on a weekly basis. In addition, participants in this group will complete a home treatment program for 30 minutes, five times a week.

Standard Care Treatment

Group of subjects receiving a 10 week standard care treatment program for frozen shoulder in addition to 5 days per week home treatment program based on conventional physiotherapy

Group Type EXPERIMENTAL

Standard Care Treatment

Intervention Type OTHER

The standard physiotherapy group will receive a 10-session treatment program that will include one corticosteroid infiltration provided in the early acute stage followed by a multimodal physiotherapy program including analgesic modalities (e.g. TENS, cryotherapy) and exercise and manual therapy techniques addressing the specific mobility deficits of each patient. This program also include a home treatment based on conventional physiotherapy that involves a training load comparable to that in the CNS-focused group.

Interventions

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CNS-focused treatment

The CNS-focused treatment will last for 10 weeks, conducted in 60-minute sessions on a weekly basis. In addition, participants in this group will complete a home treatment program for 30 minutes, five times a week.

Intervention Type OTHER

Standard Care Treatment

The standard physiotherapy group will receive a 10-session treatment program that will include one corticosteroid infiltration provided in the early acute stage followed by a multimodal physiotherapy program including analgesic modalities (e.g. TENS, cryotherapy) and exercise and manual therapy techniques addressing the specific mobility deficits of each patient. This program also include a home treatment based on conventional physiotherapy that involves a training load comparable to that in the CNS-focused group.

Intervention Type OTHER

Other Intervention Names

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graded motor and sensory imagery traininng Conventional physiotherapy treatment

Eligibility Criteria

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Inclusion Criteria

* Primary or idiopathic Frozen Shoulder (FS), defined as FS not associated with a systemic condition or history of injury
* greater than 50% reduction in passive external rotation when compared to the uninvolved shoulder or less than 30° of external rotation
* range of motion loss of greater than 25% in at least two movement planes in comparison to the uninvolved shoulder
* pain and restricted movement present for at least one month reaching a plateau or worsening
* normal shoulder X-rays (with the exception of osteopenia of the humeral head and calcific tendinosis)

Exclusion Criteria

* Locked dislocations, arthritis, fractures or avascular necrosis on radiographs
* surgery in the upper quadrant region \<12 months prior to the study
* skin or medical conditions that prevents from receiving tactile stimuli on the shoulder
* neurological or motor disorders including a diagnosis of dyslexia or difficulty performing a rapid naming task
* visually and mental health conditions that precludes successful participation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Valencia

OTHER

Sponsor Role lead

Responsible Party

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Enrique Lluch Girbés

PhD Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Enrique Lluch, PhD

Role: STUDY_DIRECTOR

Physiotherapy Department University of Valencia

Locations

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University of Valencia

Valencia, , Spain

Site Status

Countries

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Spain

References

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Wand BM, O'Connell NE, Di Pietro F, Bulsara M. Managing chronic nonspecific low back pain with a sensorimotor retraining approach: exploratory multiple-baseline study of 3 participants. Phys Ther. 2011 Apr;91(4):535-46. doi: 10.2522/ptj.20100150. Epub 2011 Feb 24.

Reference Type RESULT
PMID: 21350034 (View on PubMed)

Louw A, Puentedura EJ, Reese D, Parker P, Miller T, Mintken PE. Immediate Effects of Mirror Therapy in Patients With Shoulder Pain and Decreased Range of Motion. Arch Phys Med Rehabil. 2017 Oct;98(10):1941-1947. doi: 10.1016/j.apmr.2017.03.031. Epub 2017 May 5.

Reference Type RESULT
PMID: 28483657 (View on PubMed)

Moseley GL. Do training diaries affect and reflect adherence to home programs? Arthritis Rheum. 2006 Aug 15;55(4):662-4. doi: 10.1002/art.22086. No abstract available.

Reference Type RESULT
PMID: 16874790 (View on PubMed)

Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil. 2011 Dec;92(12):2041-56. doi: 10.1016/j.apmr.2011.07.198.

Reference Type RESULT
PMID: 22133255 (View on PubMed)

Moseley G, Butler D, Beames T, Giles T. The graded motor imagery handbook. Adelaide: Noigroup Publishing; 2012.

Reference Type RESULT

Desroches G, Desmeules F, Gagnon DH. Characterization of humeral head displacements during dynamic glenohumeral neuromuscular control exercises using quantitative ultrasound imaging: A feasibility study. Musculoskelet Sci Pract. 2017 Jun;29:150-154. doi: 10.1016/j.msksp.2016.12.004. Epub 2016 Dec 11.

Reference Type RESULT
PMID: 28715302 (View on PubMed)

Mottram SL, Woledge RC, Morrissey D. Motion analysis study of a scapular orientation exercise and subjects' ability to learn the exercise. Man Ther. 2009 Feb;14(1):13-8. doi: 10.1016/j.math.2007.07.008. Epub 2007 Oct 1.

Reference Type RESULT
PMID: 17910930 (View on PubMed)

Mena-Del Horno S, Balasch-Bernat M, Duenas L, Reis F, Louw A, Lluch E. Laterality judgement and tactile acuity in patients with frozen shoulder: A cross-sectional study. Musculoskelet Sci Pract. 2020 Jun;47:102136. doi: 10.1016/j.msksp.2020.102136. Epub 2020 Feb 24.

Reference Type DERIVED
PMID: 32148332 (View on PubMed)

Lluch-Girbes E, Duenas L, Mena-Del Horno S, Luque-Suarez A, Navarro-Ledesma S, Louw A. A central nervous system-focused treatment approach for people with frozen shoulder: protocol for a randomized clinical trial. Trials. 2019 Aug 13;20(1):498. doi: 10.1186/s13063-019-3585-z.

Reference Type DERIVED
PMID: 31409380 (View on PubMed)

Other Identifiers

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H1507114540624

Identifier Type: -

Identifier Source: org_study_id

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