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Potential Collaboration Opportunities

Study Title: The addition of cervical Unilateral Posterior Anterior Mobilization (UPA) in the treatment of patients with shoulder impingement syndrome: A randomized clinical trial.

Study purpose: To determine whether the application of UPA’s to a comparable (or non-comparable) joint in the lower cervical region improves overall self-report of function and pain in patients with should impingement syndrome.

Inclusion Criteria: Patients diagnosed with shoulder impingement syndrome who:

1. Report pain or dysfunction with elevated (overhead) arm activities
2. Demonstrate pain during active shoulder movements
3. Demonstrate a positive Neer or Hawkins Kennedy Test
4. Report an onset that is non-traumatic
5. Demonstrate a painful arc of movement during forward elevation of the arm from 60° to 120°

Exclusion Criteria: A history of frozen shoulder (capsular pattern), disorders of the acromioclavicular joint, degenerative arthritis of the glenohumeral joint, calcifying tendonitis, shoulder instability, posttraumatic disorders, or shoulder surgery and/or elbow, hand, wrist and blatantly misdiagnosed cervical spine disorders (e.g., cervical radiculopathy).

Data Capture: Baseline, 1 week, and Discharge.

Forms: QuickDASH, NAS for Pain, Self Perceived Recovery, PASS (Patient Acceptable Symptom Trait)

Treatment: Conventional, evidence based treatment to the shoulder: Mobs, stretching, and strengthening exercises. Modalities as needed if pain is greater than 5 on the VAS. Standardized HEP for the shoulder. Only the experimental group receives UPA’s to the cervical spine; applied as 3 X 30 seconds, to each comparable (stiff or painful) segment.

Clinician Responsibilities:  What would the clinician have to do?: Randomized the subject and treat them pragmatically (like you normally would using evidence based approaches) but also provide mobs to the neck to one of the groups. You would need to collect data at baseline, 1 week, and discharge (standard forms) and consent the subject for research. You would need to mail, fax, or scan the information and send to Chad Cook.

Qualifications for Authorship: Clinicians will be listed as publication authors if enrollment of 14 subjects into the trial and ICJME guidelines of: 1) substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; 2) contribute to drafting the article or revising it critically for important intellectual content; and 3) final approval of the version to be published.

Contact Person: Chad Cook PT, PhD email:[email protected]

Forms: Contact Chad Cook

Study Title: Musculoskeletal Shoulder Disorders: Which Treatment for Whom? – Expert Consensus Workshops.

Study purpose: To identify the patient attributes (personal, clinical, physical, & diagnostic) that may affect outcome of three commonly used interventions for patients with a musculoskeletal shoulder disorder:

1. Advice, education and pain relief
2. Physiotherapy (exercise +/- manual therapy) and
3. Joint injection.

Inclusion Criteria: Expert shoulder clinicians (physiotherapists, GP’s, orthopaedic surgeons, and rheumatologists) who:

1. Are based in the U.K.
2. Clinically manage patients with shoulder disorders
3. Have a clinical or research interest in the clinical management of shoulder disorders

Exclusion Criteria: Non-expert or other clinicians, patients or other unqualified members of the public or those not based in the UK.
Data Capture: Two evening expert consensus workshops, based at ARUK Primary Care Centre, Keele University. The first workshop is planned for Wednesday, 3rd April 2013.

Clinician Responsibilities: Clinicians will be asked to provide informed consent to partake in each 2-hour evening workshop at Keele. A light evening meal and refreshments will be provided and travel expenses will be reimbursed. Clinicians will be asked to consider their recent treatment decision-making and/or referral habits for patients with a shoulder disorder. Clinicians will be asked to prepare two short annoymised case vignettes (i.e., a paper patient where the patients’ attributes including presentation, history, clinical findings are described) of patients seen in clinical practice and then referred on to or provided with (i) physiotherapy and (ii) joint injection, confident that the patient would achieve a positive clinical outcome. These case vignettes will be the basis of small group discussions to identify the patient attributes that guide or influence treatment decision-making. Clinicians will vote on the importance of all attributes raised by the group. Clinicians will consider all of the attributes as a group and collectively combine the attributes into profiles of the ideal responder to each of the three aforementioned treatment options.

Qualifications for Authorship: Contributing clinicians will be acknowledged in any publications arising from these workshops but will not be listed as authors under the ICJME guidelines for academic authorship: 1) substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; 2) contribute to drafting the article or revising it critically for important intellectual content; and 3) final approval of the version to be published.

Contact Person: Cliona McRobert email: [email protected]

References

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