| Abstrakt: |
Introduction: Shoulder pain is common, but the best treatment for it is yet to be determined. This randomized, placebo-controlled trial of manipulation (high-velocity, lowamplitude shoulder adjustment) vs. placebo (sham laser) was designed to assess the efficacy of manipulation in the treatment of rotator cuff tendinopathy. Materials and Methods: Eighty-six patients were screened, and 60 volunteers, 30 per group (average age 42, range 18 to 76 years) with a diagnosis of rotator cuff tendinopathy (supraspinatus tendinopathy) were randomized into two groups. Outcome measures included the Numerical Pain Rating Scale- 101 (NRS-101), algometry, and goniometry. Full power was calculated at 95%, requiring a sample size of N=144 with α set at p=0.05. Results: The unpaired t-test demonstrated a significant difference in favor of adjusting (Group 1) for algometry and goniometry (p⩽0.05). Friedman's test, however, determined that for Group 1, there were statistically significant and clinically meaningful decreases in the NRS-101 and significantly increased global range of motion (ROM) at final consultation in flexion, extension, abduction, adduction, external rotation, and horizontal abduction (all p<0.05). Five patients dropped out and were replaced in the placebo group; none dropped out in the adjustment group. There were no serious adverse events. Blind assessors, longer follow-up, and functional outcome measures will improve future studies. Conclusion: In this study, shoulder manipulation appeared efficacious (algometry, goniometric ROM) in short-term relief of rotator cuff tendinopathy vs. placebo (p⩽0.05). Regarding within-group change, there were also statistically significant and clinically meaningful decreased pain and increased global ROM with shoulder manipulation (p⩽0.05). Without full power, these data must be viewed with caution, but the results clearly merit further research. [ABSTRACT FROM AUTHOR] |
