Mulligan Concept Mobilisation With Movement for Shoulder Dysfunction in Older Adults

NCT02217540 | Completed

• 1 other identifier: Lirio-001-UAH
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

Objective: To pilot the methods proposed for conducting a full randomised clinical trial to evaluate the effect of Mulligan concept mobilization with movement on shoulder functionality in older adults with shoulder dysfunction. Design: Pilot randomised, single-blinded clinical trial. Setting: Three nursing homes, Toledo, Spain. Participants: 44 older adults with shoulder dysfunction. Interventions: Participants will be randomly allocated into control group (n=22) treated with a physiotherapy standard protocol proposed by the Spanish Rheumatology Society; and experimental group (n=22) treated with the same physical therapy standard protocol and Mulligan concept mobilisation with movement. Both interventions will take place three times a week for 2 consecutive weeks. Main outcomes: Primary outcome is shoulder functionality measured with Shoulder Disability Questionnaire (S-SDQ) Spanish version, and secondary outcomes are active glenohumeral range of motion and pain intensity. Data will be collected at baseline, after each group intervention, and 1 and 3 months after finishing interventions.

Conditions

Disorder of Shoulder

Keywords

Shoulder, disability evaluation, physiotherapy modalities

Outcome Measures

Primary Outcomes (1)

• Spanish-Shoulder Disability Questionnaire

  SDQ is mostly used in research and clinical practice in several countries and its score can range from minimum \[0=no functional limitation\] to maximum \[100= affirmative to all items\], so higher scores mean higher disability

  baseline and 3 times after interventions

Secondary Outcomes (1)

• Range of motion and pain

  baseline and 3 times after intervention

Study Arms (2)

Experimental Group

EXPERIMENTAL

Experimental Group consist of the physiotherapy standard protocol and active movement plus accessory mobilizations of the humeral head using Mulligan Concept Mobilisation with Movement.

Other: Standard protocol; Other: Mulligan Concept Mobilisation with Movement

Control Group

ACTIVE COMPARATOR

Standard protocol proposed by the Spanish Rheumatology Society for shoulder dysfunction

Other: Standard protocol

Interventions

Standard protocol OTHER

Control group intervention is the physiotherapy treatment standard protocol proposed by the Spanish Rheumatology Society for shoulder dysfunction

Also known as: Standard protocol for shoulder pain of Spanish Rheumatology Society

Control Group; Experimental Group

Mulligan Concept Mobilisation with Movement OTHER

The internal hand of the physiotherapist stabilises participants´ shoulder girdle and with the thenar eminence of the other hand, performs a posterior-lateral glide of the humeral head. Participants are asked to raise the affected arm in the point of pain onset while the physiotherapist sustains the gliding force to humeral head. The physiotherapist tries to maintain the glide at right angles to the plane of movement throughout the entire range while participants are requested to perform an active elevation. Participants are instructed that the mobilisation procedure, including shoulder movement, had to be pain free

Experimental Group

Eligibility Criteria

• Age: 65 Years - 100 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• to be over 65 years old
• diagnosed with shoulder dysfunction (shoulder pain and/or limited AROM in the last 4 weeks) by their physician
• dependent on at least 1 ADL
• with a limited glenohumeral AROM of 25% - 75%
• resident in the nursing homes where the study took place.

You may not qualify if:

• subjects with moderate or severe cognitive impairment
• specific rheumatic diseases, osteoarthritis, neoplasms
• shoulder joint instability
• circulatory disorders (hemophilia, clotting problems)
• skin problems aggravated by contact with the skin
• traumas in the past month
• bilateral shoulder disorders

Sponsors & Collaborators

• University of Alcala: lead

Study Sites (1)

Mensajeros de la Paz

Villarrubia de Santiago, Toledo, 45360, Spain

Location

Related Publications (18)

• Knebl JA, Shores JH, Gamber RG, Gray WT, Herron KM. Improving functional ability in the elderly via the Spencer technique, an osteopathic manipulative treatment: a randomized, controlled trial. J Am Osteopath Assoc. 2002 Jul;102(7):387-96.

  PMID: 12138953 BACKGROUND

• van den Dolder PA, Roberts DL. A trial into the effectiveness of soft tissue massage in the treatment of shoulder pain. Aust J Physiother. 2003;49(3):183-8. doi: 10.1016/s0004-9514(14)60238-5.

  PMID: 12952518 BACKGROUND

• Mulligan BR. Manual Therapy 'NAGS', 'SNAGS', 'MWMS' etc. 6 ed. Wellington: Orthopedic Physical Therapy Products; 2010

  BACKGROUND

• Teys P, Bisset L, Vicenzino B. The initial effects of a Mulligan's mobilization with movement technique on range of movement and pressure pain threshold in pain-limited shoulders. Man Ther. 2008 Feb;13(1):37-42. doi: 10.1016/j.math.2006.07.011. Epub 2006 Oct 27.

  PMID: 17070090 BACKGROUND

• Eggermont LH, Leveille SG, Shi L, Kiely DK, Shmerling RH, Jones RN, Guralnik JM, Bean JF. Pain characteristics associated with the onset of disability in older adults: the maintenance of balance, independent living, intellect, and zest in the Elderly Boston Study. J Am Geriatr Soc. 2014 Jun;62(6):1007-16. doi: 10.1111/jgs.12848. Epub 2014 May 13.

  PMID: 24823985 RESULT

• Chard MD, Hazleman R, Hazleman BL, King RH, Reiss BB. Shoulder disorders in the elderly: a community survey. Arthritis Rheum. 1991 Jun;34(6):766-9. doi: 10.1002/art.1780340619.

  PMID: 2053923 RESULT

• Vermeulen J, Neyens JC, van Rossum E, Spreeuwenberg MD, de Witte LP. Predicting ADL disability in community-dwelling elderly people using physical frailty indicators: a systematic review. BMC Geriatr. 2011 Jul 1;11:33. doi: 10.1186/1471-2318-11-33.

  PMID: 21722355 RESULT

• Koh ES, Jae-Young L. The management of shoulder pain in the elderly: focusing on clinical characteristics and conservative treatment. J Korean Geriatr Soc 2013;17(1):1-6

  RESULT

• Chester R, Shepstone L, Lewis JS, Jerosch-Herold C. Predicting response to physiotherapy treatment for musculoskeletal shoulder pain: protocol for a longitudinal cohort study. BMC Musculoskelet Disord. 2013 Jun 21;14:192. doi: 10.1186/1471-2474-14-192.

  PMID: 23800352 RESULT

• Brudvig TJ, Kulkarni H, Shah S. The effect of therapeutic exercise and mobilization on patients with shoulder dysfunction : a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2011 Oct;41(10):734-48. doi: 10.2519/jospt.2011.3440. Epub 2011 Sep 4.

  PMID: 21891875 RESULT

• Camarinos J, Marinko L. Effectiveness of manual physical therapy for painful shoulder conditions: a systematic review. J Man Manip Ther. 2009;17(4):206-15. doi: 10.1179/106698109791352076.

  PMID: 20140151 RESULT

• de Vries NM, van Ravensberg CD, Hobbelen JS, Olde Rikkert MG, Staal JB, Nijhuis-van der Sanden MW. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Res Rev. 2012 Jan;11(1):136-49. doi: 10.1016/j.arr.2011.11.002. Epub 2011 Nov 11.

  PMID: 22101330 RESULT

• Chou CH, Hwang CL, Wu YT. Effect of exercise on physical function, daily living activities, and quality of life in the frail older adults: a meta-analysis. Arch Phys Med Rehabil. 2012 Feb;93(2):237-44. doi: 10.1016/j.apmr.2011.08.042.

  PMID: 22289232 RESULT

• Hurschler C, Wulker N, Mendila M. The effect of negative intraarticular pressure and rotator cuff force on glenohumeral translation during simulated active elevation. Clin Biomech (Bristol). 2000 Jun;15(5):306-14. doi: 10.1016/s0268-0033(99)00088-1.

  PMID: 10758290 RESULT

• Vicenzino B, Paungmali A, Teys P. Mulligan's mobilization-with-movement, positional faults and pain relief: current concepts from a critical review of literature. Man Ther. 2007 May;12(2):98-108. doi: 10.1016/j.math.2006.07.012. Epub 2006 Sep 7.

  PMID: 16959529 RESULT

• Ho CY, Sole G, Munn J. The effectiveness of manual therapy in the management of musculoskeletal disorders of the shoulder: a systematic review. Man Ther. 2009 Oct;14(5):463-74. doi: 10.1016/j.math.2009.03.008. Epub 2009 May 21.

  PMID: 19467911 RESULT

• Alvarez-Nemegyei J, Puerto-Ceballos I, Guzman-Hau W, Bassol-Perea A, Nuno-Gutierrez BL. Development of a Spanish-language version of the Shoulder Disability Questionnaire. J Clin Rheumatol. 2005 Aug;11(4):185-7. doi: 10.1097/01.rhu.0000173229.50674.31.

  PMID: 16357754 RESULT

• Jones KR, Fink R, Hutt E, Vojir C, Pepper GA, Scott-Cawiezell J, Mellis BK. Measuring pain intensity in nursing home residents. J Pain Symptom Manage. 2005 Dec;30(6):519-27. doi: 10.1016/j.jpainsymman.2005.05.020.

  PMID: 16376738 RESULT

MeSH Terms

Interventions

AIEOP acute lymphoblastic leukemia protocol; Movement

Intervention Hierarchy (Ancestors)

Physiological Phenomena; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Cristina Lirio Romero, MsC

  University of Alcala

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MSc. PhD student

Study Record Dates

• First Submitted: August 13, 2014
• First Posted: August 15, 2014
• Study Start: January 1, 2012
• Primary Completion: January 1, 2013
• Study Completion: March 1, 2013
• Last Updated: December 4, 2023

Record last verified: 2014-08

Locations

ES (1)