Exercise vs. Supplements in Rotator Cuff-Related Shoulder Pain

NCT ID: NCT05976035

Last Updated: 2025-03-24

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

58 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-01

Study Completion Date

2026-12-01

Brief Summary

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Rotator cuff-related shoulder pain is a pathology characterized by pain and functional impairment originating from one or more rotator cuff tendons. The lifetime incidence of rotator cuff-related shoulder pain is around 67%, with an annual incidence exceeding 1%. Many patients continue to experience pain and functional loss for up to one year, and more than half of the patients report shoulder pain persisting for over three years.

The pathophysiology underlying rotator cuff-related shoulder pain continues to be a subject of ongoing research and uncertainty, with many aspects yet to be fully elucidated. The most common belief regarding its pathogenesis involves the role of inflammation. This hypothesis is supported by the accumulation of inflammatory cells in tendons, oxidative stress, and increased levels of pro-inflammatory cytokines. In tendon pathologies with inflammatory cell accumulation and increased cytokine levels, the use of antioxidants and anti-inflammatory agents in addition to conservative treatment contributes to tendon healing. Anti-oxidants and anti-inflammatories are substances capable of preventing or delaying certain cell damage.The use of anti-inflammatory and antioxidant supplements such as Vitamin C (Vit-C), Vitamin D (Vit-D), Omega-3, and Magnesium (Mg) is recommended. Despite indicating exercise as the gold standard for managing rotator cuff-related shoulder pain and the demonstrated anti-inflammatory and anti-oxidant properties of the mentioned supplements, there are still gaps in the understanding of their effectiveness in rotator cuff-related shoulder pain.

Based on these gaps, the goal of this study is to investigate the effects of supplements (Vit-C, Vit-D, Omega-3, and Mg) given in addition to exercise on patients' blood parameters (TNF-a, IL-6, and CRP levels), pain, functional status, quality of life, and patient satisfaction in individuals with rotator cuff-related shoulder pain.

Detailed Description

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58 participants older than 40 years of age with rotator cuff-related shoulder pain for at least 3 months will be included in the study. Signed voluntary consent will be obtained from the patients. Participants will be divided into two groups. Study groups will be as follows: a) Exercise \& Supplement Group and b) Exercise Group.

Conditions

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Rotator Cuff Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be divided into two groups with equal numbers by computer randomization method.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The investigator administering the treatment and the investigator performing the assessment will be different. The assessor will not know about the interventions that the participants received.

Study Groups

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Exercise & Supplement Group

Exercise \& Supplement group will take supplements that are prescribed by the orthopedist every day for 8 weeks in addition to a structured exercise program under the supervision of a physiotherapist 3 days per week for 8 weeks.

Group Type ACTIVE_COMPARATOR

Exercise

Intervention Type OTHER

Structured exercise program under the supervision of a physiotherapist 3 days per week for 8 weeks

Supplement

Intervention Type OTHER

Receiving supplement that are prescribed by a orthopedist every day for 8 weeks

Exercise Group

Exercise group will follow a structured exercise program under the supervision of a physiotherapist 3 days per week for 8 weeks.

Group Type ACTIVE_COMPARATOR

Exercise

Intervention Type OTHER

Structured exercise program under the supervision of a physiotherapist 3 days per week for 8 weeks

Interventions

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Exercise

Structured exercise program under the supervision of a physiotherapist 3 days per week for 8 weeks

Intervention Type OTHER

Supplement

Receiving supplement that are prescribed by a orthopedist every day for 8 weeks

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Being over the age of 40
* Diagnosing with rotator cuff-related shoulder pain confirming through clinical examination (Hawkins Kennedy and Empty Can tests) and MRI imaging
* Having shoulder pain for at least three months

Exclusion Criteria

* Having full-thickness or massive rotator cuff tear,
* Having a history of symptoms onset due to trauma,
* Having a history of surgery on the same shoulder,
* Having shoulder passive external rotation \<30° and flexion \<120°,
* Having shoulder instability,
* Having an allergy to any supplement,
* Having psychological, emotional, or cognitive problems
* Presence of shoulder problems caused by systemic diseases,
* Presence of diabetes, presence of pregnancy or breastfeeding,
* Malignancy.
Minimum Eligible Age

40 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istanbul University - Cerrahpasa

OTHER

Sponsor Role lead

Responsible Party

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Aysenur Erekdag

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Derya Çelik, Prof.

Role: STUDY_DIRECTOR

Istanbul University - Cerrahpasa

Locations

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Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpaşa

Istanbul, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Central Contacts

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Derya Çelik, Prof

Role: CONTACT

+905327940169

Facility Contacts

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Derya Çelik, Prof

Role: primary

+905327940169

References

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Lewis J, McCreesh K, Roy JS, Ginn K. Rotator Cuff Tendinopathy: Navigating the Diagnosis-Management Conundrum. J Orthop Sports Phys Ther. 2015 Nov;45(11):923-37. doi: 10.2519/jospt.2015.5941. Epub 2015 Sep 21.

Reference Type BACKGROUND
PMID: 26390274 (View on PubMed)

Luime JJ, Koes BW, Hendriksen IJ, Burdorf A, Verhagen AP, Miedema HS, Verhaar JA. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol. 2004;33(2):73-81. doi: 10.1080/03009740310004667.

Reference Type BACKGROUND
PMID: 15163107 (View on PubMed)

Tashjian RZ. Epidemiology, natural history, and indications for treatment of rotator cuff tears. Clin Sports Med. 2012 Oct;31(4):589-604. doi: 10.1016/j.csm.2012.07.001. Epub 2012 Aug 30.

Reference Type BACKGROUND
PMID: 23040548 (View on PubMed)

Macfarlane GJ, Hunt IM, Silman AJ. Predictors of chronic shoulder pain: a population based prospective study. J Rheumatol. 1998 Aug;25(8):1612-5.

Reference Type BACKGROUND
PMID: 9712108 (View on PubMed)

Litchfield R. Progressive strengthening exercises for subacromial impingement syndrome. Clin J Sport Med. 2013 Jan;23(1):86-7. doi: 10.1097/JSM.0b013e31827e9fb5.

Reference Type BACKGROUND
PMID: 23269329 (View on PubMed)

Vaysman M, Alben M, Todd M, Ruotolo C. Pharmacologic Enhancement of Rotator Cuff Repair: A Narrative Review. Orthop Rev (Pavia). 2022 Sep 4;14(3):37782. doi: 10.52965/001c.37782. eCollection 2022.

Reference Type BACKGROUND
PMID: 36072503 (View on PubMed)

Yuan T, Qian H, Yu X, Meng J, Lai CT, Jiang H, Zhao JN, Bao NR. Proteomic analysis reveals rotator cuff injury caused by oxidative stress. Ther Adv Chronic Dis. 2021 Mar 17;12:2040622320987057. doi: 10.1177/2040622320987057. eCollection 2021.

Reference Type BACKGROUND
PMID: 33796243 (View on PubMed)

Metsios GS, Moe RH, Kitas GD. Exercise and inflammation. Best Pract Res Clin Rheumatol. 2020 Apr;34(2):101504. doi: 10.1016/j.berh.2020.101504. Epub 2020 Apr 2.

Reference Type BACKGROUND
PMID: 32249021 (View on PubMed)

Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, Harris JD. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev. 2018 Mar 23;2(3):e088. doi: 10.5435/JAAOSGlobal-D-17-00088. eCollection 2018 Mar.

Reference Type BACKGROUND
PMID: 30211382 (View on PubMed)

Celik D, Atalar AC, Demirhan M, Dirican A. Translation, cultural adaptation, validity and reliability of the Turkish ASES questionnaire. Knee Surg Sports Traumatol Arthrosc. 2013 Sep;21(9):2184-9. doi: 10.1007/s00167-012-2183-3. Epub 2012 Aug 30.

Reference Type BACKGROUND
PMID: 22932692 (View on PubMed)

Beaton DE, Wright JG, Katz JN; Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am. 2005 May;87(5):1038-46. doi: 10.2106/JBJS.D.02060.

Reference Type BACKGROUND
PMID: 15866967 (View on PubMed)

Cinar-Medeni O, Ozengin N, Baltaci G, Duzgun I. Turkish version of the Rotator Cuff Quality of Life questionnaire in rotator cuff-impaired patients. Knee Surg Sports Traumatol Arthrosc. 2015 Feb;23(2):591-5. doi: 10.1007/s00167-014-3290-0. Epub 2014 Sep 11.

Reference Type BACKGROUND
PMID: 25209207 (View on PubMed)

Kamper SJ, Maher CG, Mackay G. Global rating of change scales: a review of strengths and weaknesses and considerations for design. J Man Manip Ther. 2009;17(3):163-70. doi: 10.1179/jmt.2009.17.3.163.

Reference Type BACKGROUND
PMID: 20046623 (View on PubMed)

Matthews TJ, Hand GC, Rees JL, Athanasou NA, Carr AJ. Pathology of the torn rotator cuff tendon. Reduction in potential for repair as tear size increases. J Bone Joint Surg Br. 2006 Apr;88(4):489-95. doi: 10.1302/0301-620X.88B4.16845.

Reference Type BACKGROUND
PMID: 16567784 (View on PubMed)

Millar NL, Hueber AJ, Reilly JH, Xu Y, Fazzi UG, Murrell GA, McInnes IB. Inflammation is present in early human tendinopathy. Am J Sports Med. 2010 Oct;38(10):2085-91. doi: 10.1177/0363546510372613. Epub 2010 Jul 1.

Reference Type BACKGROUND
PMID: 20595553 (View on PubMed)

Andersson G, Backman LJ, Scott A, Lorentzon R, Forsgren S, Danielson P. Substance P accelerates hypercellularity and angiogenesis in tendon tissue and enhances paratendinitis in response to Achilles tendon overuse in a tendinopathy model. Br J Sports Med. 2011 Oct;45(13):1017-22. doi: 10.1136/bjsm.2010.082750. Epub 2011 May 2.

Reference Type BACKGROUND
PMID: 21540192 (View on PubMed)

Other Identifiers

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A-3456789876

Identifier Type: -

Identifier Source: org_study_id

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