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

Littlewood, Chris; Bateman, Marcus; Brown, Kim; Bury, Julie; Mawson, Sue; May, Stephen; Walters, Stephen J.

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.

Citation

Littlewood, C., Bateman, M., Brown, K., Bury, J., Mawson, S., May, S., & Walters, S. J. (2016). A self-managed single exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy: A randomised controlled trial (the SELF study). Clinical Rehabilitation, 30(7), 686-696. https://doi.org/10.1177/0269215515593784

• Journal Article Type: Article
• Online Publication Date: Jul 9, 2015
• Publication Date: 2016-01
• Deposit Date: Dec 18, 2024
• Journal: Clinical Rehabilitation
• Print ISSN: 0269-2155
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 30
• Issue: 7
• Pages: 686-696
• DOI: https://doi.org/10.1177/0269215515593784
• Keywords: exercise, quality of life, rehabilitation, Rotator cuff tendinopathy, self-management
• Related Public URLs: https://eprints.whiterose.ac.uk/87978/3/WRRO_87978.pdf