scholarly journals Exercise therapy after corticosteroid injection for moderate to severe shoulder pain: large pragmatic randomised trial

BMJ ◽  
2010 ◽  
Vol 340 (jun28 1) ◽  
pp. c3037-c3037 ◽  
Author(s):  
D. P. Crawshaw ◽  
P. S. Helliwell ◽  
E. M. A. Hensor ◽  
E. M. Hay ◽  
S. J. Aldous ◽  
...  
BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e050101
Author(s):  
Pieter F van Doorn ◽  
Evelien I T de Schepper ◽  
Dieuwke Schiphof ◽  
Ramon P G Ottenheijm ◽  
Marloes Thoomes-de Graaf ◽  
...  

IntroductionShoulder pain is common and the prognosis is often unfavourable. Dutch guidelines on the treatment of shoulder pain in primary care recommend a corticosteroid injection or a referral to exercise therapy, if initial pain management fails and pain persists. However, evidence of the effectiveness of a corticosteroid injection compared with exercise therapy, especially in the long term, is limited. This trial will assess the clinical effectiveness and cost effectiveness of a corticosteroid injection compared with physiotherapist-led exercise therapy over 12 months follow-up in patients with shoulder pain in primary care.Methods and analysisThe SIX Study is a multicentre, pragmatic randomised clinical trial in primary care. A total of 213 patients with shoulder pain, aged ≥18 years presenting in general practice will be included. Patients will be randomised (1:1) into two groups: a corticosteroid injection or 12 sessions of physiotherapist-led exercise therapy. The effect of the allocated treatment will be assessed through questionnaires at 6 weeks and after 3, 6, 9 and 12 months. The primary outcome is patient’s reported shoulder pain-intensity and function, measured with the Shoulder Pain and Disability Index, over 12 months follow-up. Secondary outcomes include cost effectiveness, pain-intensity, function, health-related quality of life, sleep quality, patient’s global perceived effect, work absence, healthcare utilisation and adverse events. Between group differences will be evaluated using a repeated measurements analysis with linear effects models. A cost-utility analysis will be performed to assess the cost effectiveness using quality-adjusted life years from a medical and societal perspective.Ethics and disseminationThis study was approved by the Medical Ethics Committee of Erasmus MC University Medical Center Rotterdam (MEC 2020-0300). All participants will give written informed consent prior to data collection. The results from this study will be disseminated in international journals and implemented in the primary care guidelines on shoulder pain.Trial registration numberDutch Trial Registry (NL8854).


Trials ◽  
2013 ◽  
Vol 14 (1) ◽  
pp. 425 ◽  
Author(s):  
Tim A Holt ◽  
David Mant ◽  
Andrew Carr ◽  
Stephen Gwilym ◽  
David Beard ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Jianqi Fang ◽  
Liying Zhang ◽  
Fangzhen Wu ◽  
Jiajia Ye ◽  
Shuhe Cai ◽  
...  

Objectives. Baduanjin exercise is a form of Qigong exercise therapy that has become increasingly popular worldwide. The aims of the current systematic review were to summarize reported adverse events potentially associated with Baduanjin exercise based on currently available literature and to evaluate the quality of the methods used to monitor adverse events in the trials assessed. Methods. The English databases PubMed, Cochrane library, and EMbase were searched from inception to October 2020 using the keywords “Baduanjin” or “eight session brocade.” Only studies that included Baduanjin exercise therapy were included. Results. Forty-seven trials with a total of 3877 participants were included in this systematic review. Twenty-two studies reported protocols for monitoring adverse events, and two studies reported the occurrence of adverse events during training. The adverse events reported included palpitation, giddiness, knee pain, backache, fatigue, nervousness, dizziness, shoulder pain, chest tightness, shortness of breath, and muscle ache. Conclusions. Only two studies reported adverse events that were potentially caused by Baduanjin exercise. Adverse events related to Baduanjin exercise in patients with chronic fatigue syndrome may include muscle ache, palpitation, giddiness, knee pain, backache, fatigue, nervousness, dizziness, shoulder pain, chest tightness, and shortness of breath. Further studies conducted in accordance with the Consolidated Standards of Reporting Trials statement guideline incorporating monitoring of adverse events are recommended. Additional clinical trials in which Baduanjin exercise is used as a main intervention are needed, and further meta-analysis may be required to assess its safety and reach more informed conclusions in this regard in the future.


2021 ◽  
Vol 9 (3) ◽  
pp. 3825-3833
Author(s):  
Bhargava Shanker ◽  
◽  
D. Rajesh Reddy ◽  
N.S.S.N. Balaji ◽  
◽  
...  

Background: The shoulder is one of the most frequent sites of musculoskeletal pain, incidence of shoulder pain in primary care patients is estimated to be 11.2 per 1000 per year. a considerable number of people with shoulder pain (41%) show persistent symptoms after 1 year. Comparing the exercise therapy and ultrasound therapy (UST) for impingement syndrome. Methodology: The study was conducted at OPD of MNR Hospital in Sangareddy. The study was conducted for a period of 3 weeks. A total number of 30 subjects were selected by simple random sampling after explained to all the participants and an informed consent was taken from each subject. 30 subjects were randomly divided into 2 Groups. Exercise therapy was given to Group 1 and UST was given to Group 2. Both the Groups received exercise therapy and ultrasonic therapy in shoulder impingement syndrome. Subjects were evaluated pre and post treatment for VAS (Visual Analogue Scale) score, SPADI SCORE (Shoulder Pain and disability index) shoulder ROM. Outcome measures: VAS scale, SPADI score. Results and Discussion: To test the significance of the mean difference of two groups, unpaired t test was done. It is statistically shown that there is some significant impact in the parameters VAS, SPADI and shoulder ROM. The results showed that, group-I had more significant improvement in all parameters than group –II. Conclusion: It is concluded that exercise therapy is better than ultrasonic therapy for subjects with shoulder impingement syndrome. KEY WORDS: Exercise Therapy, Ultrasonic Therapy, Shoulder Pain and disability index, Range of Motion.


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