Limits...
Progressive high-load strength training compared with general low-load exercises in patients with rotator cuff tendinopathy: study protocol for a randomised controlled trial.

Ingwersen KG, Christensen R, Sørensen L, Jørgensen HR, Jensen SL, Rasmussen S, Søgaard K, Juul-Kristensen B - Trials (2015)

Bottom Line: Shoulder pain is the third most common musculoskeletal disorder, often affecting people's daily living and work capacity.The most common shoulder disorder is the subacromial impingement syndrome (SIS) which, among other pathophysiological changes, is often characterised by rotator cuff tendinopathy.The primary outcome measure will be change from baseline to 12 weeks in the patient-reported outcome Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.

View Article: PubMed Central - PubMed

Affiliation: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230, Odense, Denmark. kingwersen@health.sdu.dk.

ABSTRACT

Background: Shoulder pain is the third most common musculoskeletal disorder, often affecting people's daily living and work capacity. The most common shoulder disorder is the subacromial impingement syndrome (SIS) which, among other pathophysiological changes, is often characterised by rotator cuff tendinopathy. Exercise is often considered the primary treatment option for rotator cuff tendinopathy, but there is no consensus on which exercise strategy is the most effective. As eccentric and high-load strength training have been shown to have a positive effect on patella and Achilles tendinopathy, the aim of this trial is to compare the efficacy of progressive high-load exercises with traditional low-load exercises in patients with rotator cuff tendinopathy.

Methods/design: The current study is a randomised, participant- and assessor-blinded, controlled multicentre trial. A total of 260 patients with rotator cuff tendinopathy will be recruited from three outpatient shoulder departments in Denmark, and randomised to either 12 weeks of progressive high-load strength training or to general low-load exercises. Patients will receive six individually guided exercise sessions with a physiotherapist and perform home-based exercises three times a week. The primary outcome measure will be change from baseline to 12 weeks in the patient-reported outcome Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.

Discussion: Previous studies of exercise treatment for SIS have not differentiated between subgroups of SIS and have often had methodological flaws, making it difficult to specifically design target treatment for patients diagnosed with SIS. Therefore, it was considered important to focus on a subgroup such as tendinopathy, with a specific tailored intervention strategy based on evidence from other regions of the body, and to clearly describe the intervention in a methodologically strong study.

Trial registration: The trial was registered with Clinicaltrials.gov ( NCT01984203 ) on 31 October 2013.

No MeSH data available.


Related in: MedlinePlus

Expected flow of participants through the study. LLE: low-load exercises; PHLE: Progressive high-load exercises.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4318133&req=5

Fig1: Expected flow of participants through the study. LLE: low-load exercises; PHLE: Progressive high-load exercises.

Mentions: This trial, called the Rotator Cuff Tendinopathy Exercise (RoCTEx) trial, is a multicentre (three sites), stratified (by corticosteroid injection (yes or no)), randomised, controlled, observer- and patient-blinded superiority trial, with a two-group parallel design, to be conducted in Denmark. The primary endpoint will be 12 weeks after baseline. Patients will be randomised to either progressive high-load exercises or low-load exercises (block randomisation with a 1:1 allocation). As illustrated in Figure 1, patients will also be assessed at one year from the baseline, referred to as the follow-up assessment.Figure 1


Progressive high-load strength training compared with general low-load exercises in patients with rotator cuff tendinopathy: study protocol for a randomised controlled trial.

Ingwersen KG, Christensen R, Sørensen L, Jørgensen HR, Jensen SL, Rasmussen S, Søgaard K, Juul-Kristensen B - Trials (2015)

Expected flow of participants through the study. LLE: low-load exercises; PHLE: Progressive high-load exercises.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4318133&req=5

Fig1: Expected flow of participants through the study. LLE: low-load exercises; PHLE: Progressive high-load exercises.
Mentions: This trial, called the Rotator Cuff Tendinopathy Exercise (RoCTEx) trial, is a multicentre (three sites), stratified (by corticosteroid injection (yes or no)), randomised, controlled, observer- and patient-blinded superiority trial, with a two-group parallel design, to be conducted in Denmark. The primary endpoint will be 12 weeks after baseline. Patients will be randomised to either progressive high-load exercises or low-load exercises (block randomisation with a 1:1 allocation). As illustrated in Figure 1, patients will also be assessed at one year from the baseline, referred to as the follow-up assessment.Figure 1

Bottom Line: Shoulder pain is the third most common musculoskeletal disorder, often affecting people's daily living and work capacity.The most common shoulder disorder is the subacromial impingement syndrome (SIS) which, among other pathophysiological changes, is often characterised by rotator cuff tendinopathy.The primary outcome measure will be change from baseline to 12 weeks in the patient-reported outcome Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.

View Article: PubMed Central - PubMed

Affiliation: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230, Odense, Denmark. kingwersen@health.sdu.dk.

ABSTRACT

Background: Shoulder pain is the third most common musculoskeletal disorder, often affecting people's daily living and work capacity. The most common shoulder disorder is the subacromial impingement syndrome (SIS) which, among other pathophysiological changes, is often characterised by rotator cuff tendinopathy. Exercise is often considered the primary treatment option for rotator cuff tendinopathy, but there is no consensus on which exercise strategy is the most effective. As eccentric and high-load strength training have been shown to have a positive effect on patella and Achilles tendinopathy, the aim of this trial is to compare the efficacy of progressive high-load exercises with traditional low-load exercises in patients with rotator cuff tendinopathy.

Methods/design: The current study is a randomised, participant- and assessor-blinded, controlled multicentre trial. A total of 260 patients with rotator cuff tendinopathy will be recruited from three outpatient shoulder departments in Denmark, and randomised to either 12 weeks of progressive high-load strength training or to general low-load exercises. Patients will receive six individually guided exercise sessions with a physiotherapist and perform home-based exercises three times a week. The primary outcome measure will be change from baseline to 12 weeks in the patient-reported outcome Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.

Discussion: Previous studies of exercise treatment for SIS have not differentiated between subgroups of SIS and have often had methodological flaws, making it difficult to specifically design target treatment for patients diagnosed with SIS. Therefore, it was considered important to focus on a subgroup such as tendinopathy, with a specific tailored intervention strategy based on evidence from other regions of the body, and to clearly describe the intervention in a methodologically strong study.

Trial registration: The trial was registered with Clinicaltrials.gov ( NCT01984203 ) on 31 October 2013.

No MeSH data available.


Related in: MedlinePlus