Self-managed loaded exercise versus usual physiotherapy treatment for rotator cuff tendinopathy

Rotator cuff tendinopathy is often the cause of shoulder pain characterised by persistent and/or recurrent problems for a proportion of sufferers. The authors’ objective in this study was to pilot the methods proposed to conduct a substantive study to evaluate the effectiveness of a self-managed loaded exercise programme as opposed to usual physiotherapy treatment for rotator cuff tendinopathy. They conducted a single-centre pragmatic unblinded parallel group pilot randomised controlled trial at one private physiotherapy clinic, northern England. 24 individuals with rotator cuff tendinopathy were recruited.

The intervention was a programme of self-managed loaded exercise. The control group received usual physiotherapy treatment. Baseline assessment comprised the Shoulder Pain and Disability Index (SPADI) and the Short-Form 36, repeated three months after randomisation. The recruitment target was met and the majority of participants (98%) were willing to be randomised. 100% retention was attained with all participants completing the SPADI at three months. Exercise adherence rates were excellent (90%). The mean change in SPADI score was -23.7 (95% CI -14.4 to -33.3) points for the self-managed exercise group and -19.0 (95% CI -6.0 to -31.9) points for the usual physiotherapy treatment group. The difference in three month SPADI scores was 0.1 (95% CI -16.6 to 16.9) points in favour of the usual physiotherapy treatment group.

The authors concluded that in keeping with past research which suggest the need for further study of self-managed loaded exercise for rotator cuff tendinopathy, these methods and the preliminary evaluation of outcome offer a foundation and stimulus to undertake a substantive study.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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