Associate Professor Nicola Swain
University of Otago, Dunedin, NZ
Swain, N., Psychological Medicine, University of Otago, Dunedin, NZ
Sole, G., Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, NZ
Ribeiro, D.,Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, NZ
Perry, M., Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Wellington & Wassinger, C., Department of Physical Therapy, University of East Tennessee, USA
Introduction: Rotator cuff syndrome often leads to long term shoulder pain, affecting self-care, sleep, physical activity, and work. Rehabilitation is generally directed to the shoulder structures, using manual therapy and specific exercise. However, psychosocial factors and increased sensitivity of the nervous system (including the brain) also contribute towards the pain experience. A ‘neuroscience’-informed rehabilitation approach focusses on patients’ understanding of the pain and psychosocial aspects, in addition to manual therapy and exercises, to enhance self-management and self-efficacy.
Aims: This study will determine feasibility of a physiotherapy programme that integrates the neuroscience approach with regular physiotherapy in two community-based practices. This is a feasibility study so recruitment and retention is of interest as well as acceptability of the intervention.
Methods: Thirty patients have been enrolled in the study, 15 from each of two major centres. They each completed a pragmatic trial of the standard physiotherapy programme with the addition of the neuroscience information. Patients filled in surveys before and after treatment and also kept a log book. There were in-person interviews conducted with patients after the completion of the study, and a focus group with the providing physiotherapists.
Results: The intervention programme will be presented. The key outcome measure is Shoulder Pain and Disability Index, SPADI and changes will be discussed in terms of clinically meaningful differences. Estimates of the treatment effect will be calculated with change scores from baseline to programme completion for each of the clinical outcome variables. We are also analysing clinical fidelity and economic outcome data. The open-ended comments will summarised using thematic analysis.
Conclusion: Implications will be discussed for clinical practice and for a future randomised trial.