- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03090555
Translational Manipulation Under Interscalene Block for Adhesive Capsulitis of the Shoulder (TMACS) (TMACS)
The Effectiveness of Translational Manipulation Under Interscalene Block for Treatment of Adhesive Capsulitis of the Shoulder: A Randomized Clinical Trial
Study Overview
Status
Intervention / Treatment
Detailed Description
Both translational manipulation under interscalene block and in-clinic orthopaedic manual physical therapy are thought to be useful for treating adhesive capsulitis of the shoulder. However, no single intervention for this condition has been proven to be superior to others.
The translational manipulation under interscalene block may improve pain-free motion of the involved shoulder, by releasing tight tissue without the guarding and motion-limiting effect of active muscle tension. The interscalene block prevents the patient from actively contracting the muscles that control the involved shoulder, during the manipulation procedure.
One additional possible benefit of the translational manipulation under interscalene block, is that the technique loads the joint structures--bone, joint capsule--in a safer way with less angular torque than conventional/traditional manipulation under anaesthesia. This minimizes the risk of physical/mechanical harm from the procedure.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Texas
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Fort Sam Houston, Texas, United States, 78234
- Brooke Army Medical Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Military healthcare system beneficiaries 18 years old or older
- Chief complaint of loss of shoulder range of motion
- Passive glenohumeral abduction less than 75 degrees
- Sufficient English-language skills to understand the study protocol.
Exclusion Criteria:
- Clinical diagnosis of diabetes (type I or II)
- Clinically evident and symptomatic rotator cuff tear or cervical radiculopathy
- Pain as the primary impairment (versus limitation of motion as the primary impairment)
- Having contraindications to an interscalene block.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Translational Manipulation
Participants received an interscalene block on the affected side. Then, a physical therapist performed thrust manipulations on the affected shoulder until full passive physiologic motion was restored. These participants returned to the clinic approximately 3 days later for the first of 6 manual therapy (MT) sessions. The first clinic treatment session included instruction in a home program of static stretching, resistive exercise, and ice, issue of an illustrated handout and digital video disc detailing the same program, and manual therapy (MT) by a physical therapist that included all indicated grades of non-thrust manipulation. Subsequent clinic treatment sessions included additional MT, progression of the strengthening exercises, and reinforcement of the home program. |
After the patient receives an interscalene block on the affected side, a physical therapist performs a series of thrust manipulations on the participant's affected shoulder.
The participant's identified limitations of physiological and accessory motion revealed during manual examination guided the physical therapist's choice of technique, which primarily consisted of an accessory superior to inferior accessory gliding motion performed in a physiological position of limited motion.
Additional gliding manipulations in combined movement positions such as increased flexion or abduction plus internal or external rotation were utilized until full passive physiologic motion was restored.
The first clinic treatment session for all study participants included instruction in the home program of static stretching, resistive exercise, and ice, issue of an illustrated handout and digital video disc detailing the same program, and manual therapy (MT) by a physical therapist that included all indicated grades of non-thrust manipulation of the joints and soft tissue.
The MT intervention was targeted toward any identifiable upper quarter pain or movement impairments.
Subsequent clinic treatment sessions included additional MT, progression of the strengthening exercises, and reinforcement of the home program.
|
Active Comparator: Comparison Group
Participants in the comparison group did not undergo a session of translational manipulation.
In order to equalize the number of intervention sessions, members of this group underwent 7 in-clinic sessions of manual therapy (MT).
The first clinic treatment session for all study participants included instruction in the home program of static stretching, resistive exercise, and ice, issue of an illustrated handout and digital video disc detailing the same program, and MT by a physical therapist that included all indicated grades of non-thrust manipulation.
Subsequent clinic treatment sessions included additional MT, progression of the strengthening exercises, and reinforcement of the home program.
|
The first clinic treatment session for all study participants included instruction in the home program of static stretching, resistive exercise, and ice, issue of an illustrated handout and digital video disc detailing the same program, and manual therapy (MT) by a physical therapist that included all indicated grades of non-thrust manipulation of the joints and soft tissue.
The MT intervention was targeted toward any identifiable upper quarter pain or movement impairments.
Subsequent clinic treatment sessions included additional MT, progression of the strengthening exercises, and reinforcement of the home program.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Shoulder Pain and Disability Index (SPADI)
Time Frame: baseline, 3 months, 6 months, 12 months, 48 months
|
Measure of individual pain and disability
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baseline, 3 months, 6 months, 12 months, 48 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percent of normal
Time Frame: 48 months
|
Patient estimate of percent of full functional capacity of involved shoulder
|
48 months
|
Activity limitations
Time Frame: 48 months
|
Patient estimate of identified activities limited by involved shoulder function
|
48 months
|
Medication use
Time Frame: 48 months
|
Patient estimate of medications taken due to involved shoulder pain
|
48 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Daniel G. Rendeiro, DSc, Army-Baylor University Doctoral Fellowship in Orthopaedic Manual Physical Therapy
Publications and helpful links
General Publications
- Placzek JD, Roubal PJ, Kulig K, Pagett BT, Wiater JM. Theory and technique of translational manipulation for adhesive capsulitis. Am J Orthop (Belle Mead NJ). 2004 Apr;33(4):173-9.
- Placzek JD, Roubal PJ, Freeman DC, Kulig K, Nasser S, Pagett BT. Long-term effectiveness of translational manipulation for adhesive capsulitis. Clin Orthop Relat Res. 1998 Nov;(356):181-91. doi: 10.1097/00003086-199811000-00025.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- c2003.176
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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