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Clin Rehabil. 2016 Jul;30(7):686-96. doi: 10.1177/0269215515593784. Epub 2015 Jul 9.

A self-managed single exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy: a randomised controlled trial (the SELF study).

Author information

1
School of Health & Related Research, University of Sheffield, Sheffield, UK c.littlewood@sheffield.ac.uk.
2
Derby Teaching Hospitals NHS Foundation Trust, Physiotherapy Department, London Road Community Hospital, Derby, UK.
3
Solent NHS Trust, Physiotherapy Outpatient Department, St Marys Community Health Campus, Portsmouth, UK.
4
Doncaster & Bassetlaw Hospitals NHS Foundation Trust, Physiotherapy Department, Doncaster Royal Infirmary, Doncaster, UK.
5
National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research & Care (CLAHRC) for South Yorkshire, Sheffield Teaching Hospitals, Sheffield, UK.
6
Faculty of Health & Wellbeing, Sheffield Hallam University, Sheffield, UK.
7
School of Health & Related Research, University of Sheffield, Sheffield, UK.

Abstract

OBJECTIVES:

To evaluate the clinical effectiveness of a self-managed single exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy.

DESIGN:

Multi-centre pragmatic unblinded parallel group randomised controlled trial.

SETTING:

UK National Health Service.

PARTICIPANTS:

Patients with a clinical diagnosis of rotator cuff tendinopathy.

INTERVENTIONS:

The intervention was a programme of self-managed exercise prescribed by a physiotherapist in relation to the most symptomatic shoulder movement. The control group received usual physiotherapy treatment.

MAIN OUTCOME MEASURES:

The primary outcome measure was the Shoulder Pain & Disability Index (SPADI) at three months. Secondary outcomes included the SPADI at six and twelve months.

RESULTS:

A total of 86 patients (self-managed loaded exercise n=42; usual physiotherapy n=44) were randomised. Twenty-six patients were excluded from the analysis because of lack of primary outcome data at the 3 months follow-up, leaving 60 (n=27; n=33) patients for intention to treat analysis. For the primary outcome, the mean SPADI score at three months was 32.4 (SD 20.2) for the self-managed group, and 30.7 (SD 19.7) for the usual physiotherapy treatment group; mean difference adjusted for baseline score: 3.2 (95% Confidence interval -6.0 to +12.4 P = 0.49).By six and twelve months there remained no significant difference between the groups.

CONCLUSIONS:

This study does not provide sufficient evidence of superiority of one intervention over the other in the short-, mid- or long-term and hence a self-management programme based around a single exercise appears comparable to usual physiotherapy treatment.

KEYWORDS:

Rotator cuff tendinopathy; exercise; quality of life; rehabilitation; self-management

PMID:
26160149
DOI:
10.1177/0269215515593784
[Indexed for MEDLINE]
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