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

Rotator Cuff Tendinopathy (RCT) is a common source of shoulder pain characterised by persistent and/or recurrent problems for a proportion of sufferers.  The aim of this study was to pilot the methods proposed to conduct a substantive study to evaluate the effectiveness of a self-managed loaded exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy.

A single-centre pragmatic unblinded parallel group pilot randomised controlled trial wasconducted on 24 participants with RCT.  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 post randomisation. 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 points for the self-managed exercise group and −19.0 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.
In keeping with previous research, which indicates the need for further evaluation of self-managed loaded exercise for RCT, these methods and the preliminary evaluation of outcome offer a foundation and stimulus to conduct a substantive study.

From: Littlewood et al., Physiotherapy (2013) Self-managed loaded exercise versus usual physiotherapy treatment for rotator cuff tendinopathy: a pilot randomised controlled trial (Epub ahead of print).