Effect of a Shoulder Movement Intervention on Joint Mobility, Pain, and Disability in People With Diabetes: A Randomized Controlled Trial

Abstract

Background: People with diabetes are at high risk for shoulder pain, limited joint mobility, and adhesive capsulitis.

Objective: The objective of this study was to evaluate the effects of a shoulder movement intervention (ShoMo) compared to a wellness intervention on the primary outcomes of active shoulder flexion and reported Shoulder Pain and Disability Index (SPADI) measured after intervention and 9 months later.

Design: The design was a prospective, randomized, controlled clinical trial.

Setting: The setting was a research center at an academic medical center.

Participants: Fifty-two participants with type 2 diabetes and shoulder pain or limited motion were randomized to a group receiving ShoMo (N = 27; mean age = 59.3; SD = 7.0) or a group receiving wellness activities (N = 25; mean age = 57.9; SD = 7.7).

Intervention: The ShoMo group received instruction in a progressive, active shoulder movement program. The wellness group received instruction in diabetes management.

Measurements: Measurements were made at baseline, after 3 months of intervention, and at 6, 9, and 12 months after baseline.

Results: After intervention, the ShoMo group had a 7.2-degree increase in active shoulder flexion compared with the wellness group (95% CI = 0.9-13.5°), but there was no difference at subsequent follow-ups. The ShoMo group showed a 12.7-point improvement in the SPADI score compared to the wellness group after intervention (95% CI = 1.1-24.3), which remained better than the wellness group 9 months later.

Limitations: The number of participants and duration of follow-up were inadequate to determine if intervention can help to prevent future severe shoulder problems.

Conclusions: A progressive shoulder movement program can have meaningful effects on active motion and symptoms in people with type 2 diabetes and mild-to-moderate shoulder symptoms, with symptom improvement lasting at least 9 months.

Trial registration: ClinicalTrials.gov NCT02162212.

Figures

Figure 1.

CONSORT flow diagram including the number of people who attended each follow-up session and reasons people missed the follow-up session. Note that a participant could miss 1 follow-up session but remain in the study and attend subsequent follow-up sessions. T1–T5 = testing sessions 1 through 5.

Figure 2.

Means and standard error of (A) active shoulder flexion of the involved arm and (B) Shoulder Pain and Disability Index (SPADI) at baseline, immediately following treatment (3 months) and 6, 9, and 12 months after baseline. * = P < .05.