Mobilization With Movement for Shoulder Impingement

Effects of Mobilization-with-Movement on Pain and Range of Motion in Unilateral Shoulder Impingement Syndrome: A Randomized Controlled Trial

Controversy exists regarding the effectiveness of manual therapy techniques for the management of impingement syndrome. However, no adequately powered clinical trials have examined the effects of mobilization-with-movement. The purpose of the current study was to perform a randomized controlled trial comparing the effects of real MWM to a group receiving a sham intervention on shoulder pain at different moments and active shoulder range of motion in an adequately powered sample of patients with shoulder impingement syndrome.

Study Overview

• Status: Completed
• Conditions: Shoulder Impingement Syndrome
• Intervention / Treatment: Other: Real mobilization-with-movement (MWM); Other: Sham mobilization-with-movement (MWM)

• Study Type: Interventional
• Enrollment (Actual): 42
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Salamanca, Spain, 37008
    • Francisco Alburquerque Sendín

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• history of shoulder pain of > 3months duration
• pain localized at the proximal anterolateral shoulder region
• medical diagnosis of shoulder impingement syndrome
• at least 2 positive impingement tests including Neer, Hawking, or Jobe test

Exclusion Criteria:

• diagnosis of fibromyalgia
• pregnancy
• a history of traumatic onset of shoulder pain
• other histories of shoulder injury
• ligamentous laxity based on a positive Sulcus test and apprehension test
• numbness or tingling in the upper extremity
• previous shoulder or cervical spine surgery
• corticosteroid injection on the shoulder within 1 year of the study
• physical therapy 6 months prior to the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Real mobilization-with-movement (MWM); For the MWM group, an accessory posterior-lateral gliding movement in the humeral head combined with a movement of active shoulder flexion will be applied. One hand will be placed over the scapula posteriorly while the thenar eminence of the other hand will be placed over the anterior aspect of the head of the humerus	Other: Real mobilization-with-movement (MWM)
Sham Comparator: Sham mobilization-with-movement (MWM); The sham condition will replicate the treatment condition except for the hand positioning. The therapist locates one hand over the belly of the pectoralis major muscle and the other over scapula without applying any pressure. The patient will be asked to move the arm in a similar manner as in the MWM group	Other: Sham mobilization-with-movement (MWM)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in the intensity of shoulder pain before and after the treatment	Participants were asked to rate the intensity of their pain using an 11-point numerical pain rating scale (NPRS; 0: no pain; 10: maximum pain) for 3 scores of perceived pain: 1, the intensity of shoulder pain experienced in the last 24h; 2, the intensity of shoulder pain at night; 3, the intensity of shoulder pain during shoulder flexion.	Baseline and one week after intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in shoulder range of motion before and after the treatment	A universal goniometer was used to assess the participant's shoulder range of motion in the following motions: Pain-free and maximum (painful) range of motion in shoulder flexion; Pain-free range of motion in shoulder extension; Pain-free range of motion in shoulder abduction; Pain-free range of motion in shoulder external rotation; Pain-free range of motion in shoulder medial (internal) rotation	Baseline and one week after the intervention

Collaborators and Investigators

• Sponsor: César Fernández-de-las-Peñas
• Collaborators: University of Salamanca
• Investigators: Principal Investigator: Francisco Alburquerque Sendín, PT, PhD, University of Salamanca; Study Chair: César Fernández de las Peñas, PT, PhD, Universidad Rey Juan Carlos

Study record dates

Study Major Dates

• Study Start: January 1, 2013
• Primary Completion (Actual): January 1, 2014
• Study Completion (Actual): January 1, 2014

Study Registration Dates

• First Submitted: June 22, 2014
• First Submitted That Met QC Criteria: June 23, 2014
• First Posted (Estimate): June 24, 2014

Study Record Updates

• Last Update Posted (Estimate): June 24, 2014
• Last Update Submitted That Met QC Criteria: June 23, 2014
• Last Verified: June 1, 2014

More Information

Terms related to this study

• Keywords: shoulder impingement, manual therapy, pain, motion.
• Additional Relevant MeSH Terms: Pathologic Processes; Wounds and Injuries; Disease; Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Syndrome; Shoulder Impingement Syndrome
• Other Study ID Numbers: USAL201000048540

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No