Passive mobilisation of shoulder region joints plus advice and exercise does not reduce pain and disability more than advice and exercise alone: a randomised trial

Abstract

Question: Is the addition of passive mobilisation of shoulder region joints to advice and exercise for patients with shoulder pain and stiffness more effective than advice and exercise alone?

Design: Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis.

Participants: 90 people who had shoulder pain and stiffness for more than one month.

Intervention: All participants received advice and exercise. The experimental group also received passive joint mobilisation of shoulder region joints.

Outcome measures: Primary outcome measures included pain and disability measured with the 13-point Shoulder Pain and Disability Index. Secondary outcome measures were self-perceived global improvement measured on a 6-point scale and active ranges of motion. Subjects received a maximum of 10 sessions of therapy. Outcome measurements were taken at baseline, one month, and six months.

Results: The experimental group had 3% (95% CI -5 to 11) less pain and disability than the control group at one month and 1% (95% CI -13 to 16) less pain at six months, which are statistically nonsignificant. Their global perceived effect was 0.1 out of 5 (95% CI -0.2 to 0.4) worse than the control group at one month and 0.1 (95% CI -0.5 to 0.7) better at 6 months, which are also statistically non-significant. Differences between groups in all range of motion measures were small and statistically non-significant.

Conclusion: The addition of passive joint mobilisation of shoulder region joints is not more effective than advice and exercise alone for shoulder pain and stiffness.

Trial registration: ACTRN 12605000080628.