- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04190836
Self-Management for Persistent Subacromial Pain
December 6, 2019 updated by: Oslo Metropolitan University
Adherence to Self-managed Exercises for Patients With Persistent Subacromial Pain: A Feasibility Study for the Ad-Shoulder Trial
Physiotherapy-led exercises is the first line treatment for patients with subacromial pain.
However, current evidence report that most treatment programmes only show a short-term benefit.
There seem to be a potential for enhancing the effectiveness of exercise interventions by improving adherence to self-managed exercises, but there is lack of knowledge about adherence to exercise programmes in shoulder pain.
Before conducting a planned randomised controlled trial on the clinical effectiveness of an intervention focusing on adherence to a self-managed exercise strategy (the Ad-Shoulder intervention), it is necessary to run a feasibility study in order to establish whether such a resource-demanding trial is worthwhile.
Feasibility studies are designed to answer the key question "Can it work?"
The main objectives of the present study was to assess the feasibility in terms of recruitment capability, data collection procedures and acceptability of the Ad-Shoulder intervention in patients with subacromial pain receiving treatment in primary or secondary health care.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
11
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
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Oslo, Norway
- Diakonhjemmet Hospital
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Oslo, Norway
- Oslo Metropolitan University
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Pain located to the upper arm
- Had previously received conservative treatment due to subacromial pain
- Still seek primary or secondary care during the past 6 months
Exclusion Criteria:
- Frozen shoulder diagnosis (<50% external rotation compared to contralateral side)
- Patients who have received surgical treatment due to shoulder problems
- Pregnant patients
- Patients with insufficient Norwegian language skills
- Serious psychiatric disorder
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Self-Managed Exercise Strategy
|
The intervention is a personalised supported self-management intervention which emphasises dynamic, progressively loaded exercises for the shoulder.
The intervention consisted of 1-5 individual sessions provided over 3 months, with a duration of 1 hour for the first session and 45 minutes for the following.
The participants will have the opportunity to contact the physiotherapist by phone, text message or e-mail for advice during the treatment period (12 weeks).
The personalised supported self-management intervention will be based on the components of the self-management framework, provided by Lorig and Holman (2003).
The five self-management skills and the operationalization of these will be described when publishing the study.
For specific content reporting of the self managed exercises we will follow the Consensus on Exercise Reporting Template.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Recruitment rate
Time Frame: 3 months
|
How many people that were eligible and how many people that were recruited per week
|
3 months
|
Follow-up rate
Time Frame: 3 months
|
Determine the follow-up rate - measured by the percentage of participants who were followed up successfully until the three months follow-up
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3 months
|
Actigraph assessment of physical activity
Time Frame: 3 months
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Feasibility of Actigraph assessment of physical activity - measured by percentage of participants with valid data at Week 0, Week 6 and 3 months
|
3 months
|
Adherence
Time Frame: 3 months
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Determine whether the patients adhere with the self-managed exercises - measured by self-reported exercise log book
|
3 months
|
Fidelity
Time Frame: 3 months
|
Determine whether the therapists delivered the intervention as planned - measured by assessing the therapists' log book
|
3 months
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Adverse events
Time Frame: 3 months
|
Determine number and nature of adverse events via self-report questionnaire
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3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Shoulder pain and disability index (SPADI)
Time Frame: 3 months
|
SPADI is a self-reported questionnaire for patients with shoulder pain.
The questionnaire consists of 13 questions divided into two domains: pain (five items) and function (eight items) and scored on a numerical scale 0 (best) to 10 (worst) with a score range from 0 to 100 points
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3 months
|
Patient Specific Function Scale (PSFS)
Time Frame: 3 months
|
PSFS is a patient specific outcome measure where the patient is asked to name three activities which the patient find challenging or are not able to do because of their shoulder pain.
Patients rate their ability to complete the activities on a 11-point scale at a level experienced prior to injury or change in functional status.
"0" represents "unable to perform" and "10" represents "able to perform at prior level".
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3 months
|
Numeric Pain Rating Scale (NPRS)
Time Frame: 3 months
|
Pain intensity during the last week was measured using the NPRS (ranging from 0 = no pain, 10 = the most intense pain imaginable).
Repeated measures: During a one week pre-treatment phase (A), 3 times.
During the 12 week treatment phase (B): collected twice every week.
During a one week post-treatment phase (A): 3 times
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3 months
|
Pain self-efficacy 2-item short form (PSEQ-2 item)
Time Frame: 3 months
|
Measured using a 2-item questionnaire by asking the patients' how confident they are doing some form of work and to live a normal lifestyle at present, despite the pain (ranging from 0 = not at all confident, 6 = completely confident).
Repeated measures: During a one week pre-treatment phase (A), 3 times.
During the 12 week treatment phase (B): collected twice every week.
During a one week post-treatment phase (A): 3 times
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3 months
|
Self-efficacy
Time Frame: 3 months
|
Measured using one modified question from the Musculoskeletal Health Questionnaire: "How confident have you felt about managing your shoulder pain by yourself (responses were not at all confident, slightly, moderately, very and extremely)?
Repeated measures: During a one week pre-treatment phase (A), 3 times.
During the 12 week treatment phase (B): collected twice every week.
During a one week post-treatment phase (A): 3 times
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3 months
|
Working Ability Index
Time Frame: 3 months
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Work ability will be measured on a 11-point scale (0 = Can not work at all, 10 = working ability is best right now)
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3 months
|
EQ-5D-5L
Time Frame: 3 months
|
Generic health-related quality of life will be assessed by the EQ-5D.
It evaluates 5 dimensions: mobility, self-care, activities of daily living, pain, and anxiety and/or depression.
For each dimension the patient describes three possible levels of problems (none, mild-to-moderate, and severe).
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3 months
|
Global Perceived Effect scale (GPE)
Time Frame: 3 months
|
The patient rated perception of change at the follow-ups will be assessed on a Global Perceived Effect scale (GPE) at follow-up (52).
The response alternatives were: 1 = "completely recovered", 2 = "much improved", 3 = "slightly improved", 4 = "no change", 5 = "slightly worse", 6 = "much worse", and 7 = "worse than ever".
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3 months
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Bergen Insomnia Scale
Time Frame: 3 months
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Pain-interference with sleep will be assessed by the Bergen Insomnia Scale, which consists of six items.
Scoring 3 or above on at least one of the first four items and scoring 3 or above on at least one of the last two items indicate the presence of insomnia.
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3 months
|
Kinesiophobia
Time Frame: 3 months
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Kinesiophobia will be assessed using one question: "How much 'fear' do you have that these complaints would be increased by physical activity?
(scores range from 0 = no fear, to 10 = very much fear).
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3 months
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Physical activity (self-reported)
Time Frame: 3 months
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Physical activity will be assessed by the 3 questions from the Nord-Trondelag Health Study (HUNT) regarding frequency, intensity and duration.
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3 months
|
Physical activity (accelerometer)
Time Frame: 3 months
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To objectively measure physical activity an accelerometer (AX3, 3-axis Logging Accelerometer) was used.
This accelerometer provides information about movement and will enable us to objectively measure the amount of general physical activity (minutes of moderate activity).
The patients will be measured for three consecutive days at baseline, at 6 weeks and at 3 months to assess changes between the three time points (Week 0, Week 6 and 3 months.
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3 months
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Study Chair: Daniel Major, MSc, Oslo Metropolitan University
- Principal Investigator: Yngve Røe, PhD, Oslo Metropolitan University
- Study Chair: Margreth Grotle, PhD, Oslo Metropolitan University
- Study Chair: Chris Littlewood, PhD, Keele University
- Study Chair: Dagfinn Matre, PhD, National Institute of Occupational Health, Norway
- Study Chair: Heidi V Gallet, MSc, Diakonhjemmet Hospital
- Study Director: Hege Bentzen, PhD, Oslo Metropolitan University
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
November 1, 2017
Primary Completion (Actual)
September 12, 2018
Study Completion (Actual)
September 12, 2018
Study Registration Dates
First Submitted
November 18, 2019
First Submitted That Met QC Criteria
December 6, 2019
First Posted (Actual)
December 9, 2019
Study Record Updates
Last Update Posted (Actual)
December 9, 2019
Last Update Submitted That Met QC Criteria
December 6, 2019
Last Verified
December 1, 2019
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2017/355
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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