Abstract
Background Passive mobilization of shoulder region joints, often in conjunction with other treatment modalities, is used for the treatment of people with shoulder pain and minimal movement restriction. However, there is only limited evidence supporting the efficacy of this treatment modality.
Objective The purpose of this study was to determine whether passive mobilization of shoulder region joints adds treatment benefit over exercise and advice alone for people with shoulder pain and minimal movement restriction.
Design This was a randomized controlled clinical trial with short-, medium- and longer-term follow-up.
Setting The study was conducted in a metropolitan teaching hospital.
Patients Ninety-eight patients with shoulder pain of local mechanical origin and minimal shoulder movement restriction were randomly allocated to either a control group (n=51) or an experimental group (n=47).
Intervention Participants in both groups received advice and exercises designed to restore neuromuscular control at the shoulder. In addition, participants in the experimental group received passive mobilization specifically applied to shoulder region joints.
Measurements Outcome measurements of shoulder pain and functional impairment, self-rated change in symptoms, and painful shoulder range of motion were obtained at 1, 3, and 6 months after entry into the trial. All data were analyzed using the intention-to-treat principle by repeated-measures analyses of covariance.
Results No statistically significant differences were detected in any of the outcome measurements between the control and experimental groups at short-, medium-, or longer-term follow-up.
Limitations Therapists and participants were not blinded to the treatment allocation.
Conclusion This randomized controlled clinical trial does not provide evidence that the addition of passive mobilization, applied to shoulder region joints, to exercise and advice is more effective than exercise and advice alone in the treatment of people with shoulder pain and minimal movement restriction.
Footnotes
Mr Yiasemides and Associate Professor Ginn provided concept/idea/research design and project management. All authors provided writing, data analysis, and consultation (including review of manuscript before submission). Mr Yiasemides provided data collection. Associate Professor Ginn provided fund procurement, facilities/equipment, and institutional liaisons. The authors are grateful to the outpatient physical therapy staff at the Royal Prince Alfred Hospital, Sydney, Australia, for their involvement in this clinical trial.
This study was approved by the Human Research Ethics Committees of the University of Sydney and Central Sydney Area Health Services (Royal Prince Alfred Hospital).
This study was partially funded by a Musculoskeletal Physiotherapy Australia Research Grant from the Physiotherapy Research Foundation awarded in 2005.
Trial registration: ACTRN: 12605000151639.
- Received March 29, 2010.
- Accepted October 20, 2010.
