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Assessment of dynamic humeral centering in shoulder pain with impingement syndrome: a randomised clinical trial
  1. Johann Beaudreuil1,
  2. Sandra Lasbleiz1,
  3. Pascal Richette1,
  4. Gérard Seguin1,
  5. Christine Rastel1,
  6. Mounir Aout2,
  7. Eric Vicaut2,
  8. Martine Cohen-Solal1,
  9. Frédéric Lioté1,
  10. Marie-Christine de Vernejoul1,
  11. Thomas Bardin1,
  12. Philippe Orcel1
  1. 1Service de Rhumatologie, Groupe Hospitalier Lariboisière-Fernand Widal, AP-HP, Université Paris 7, Paris, France
  2. 2Unité de Recherche Clinique, Groupe Hospitalier Lariboisière-Fernand Widal, AP-HP, Université Paris 7, Paris, France
  1. Correspondence to Johann Beaudreuil, Service de Rhumatologie, 2 rue Ambroise Paré, Groupe Hospitalier Lariboisière-Fernand Widal, AP-HP, Université Paris 7, 75010 Paris, France; johann.beaudreuil{at}lrb.aphp.fr

Abstract

Objectives Treatment for degenerative rotator cuff disease of the shoulder includes physiotherapy. Dynamic humeral centering (DHC) aims at preventing subacromial impingement, which contributes to the disease. The goal of this study was to assess the effectiveness of DHC.

Method 69 patients with shoulder pain and impingement syndrome were prospectively included in a single-centre randomised trial with a 12-month follow-up. Patients and assessor were blinded to the study hypothesis and treatment, respectively. DHC and non-specific mobilisation as control were performed for 6 weeks, in 15 supervised individual outpatient sessions, and patients performed daily home exercises. The planned primary outcome was the Constant score including subscores for pain, activity, mobility and strength at 3 months. Secondary outcomes were the Constant score and subscores at 12 months, and medication use for pain at 3 and 12 months.

Results The DHC group did not differ from the control group in the total Constant score at 3 months. However, the DHC group showed a higher Constant subscore for pain (12.2 (SD 2.8) vs 9.9 (2.9), least square means difference 2.1, 95% CI 0.7 to 3.5, p=0.004). At 3 months, the DHC group also showed a higher rate of no medication use (96.7% vs 71%, proportional difference 25.7, 95% CI 3.7 to 51.9, p=0.012). There was no other intergroup difference.

Conclusions There was no difference in the total Constant score between DHC and controls. However, pain was improved at 3 months after DHC. The differences found in subscores for pain should be explored in future studies.

Trial registration clinicaltrials.gov Identifier: NCT 01022775.

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Footnotes

  • Funding Assistance Publique–Hôpitaux de Paris and the French Society of Rheumatology funded the study. Assistance Publique–Hôpitaux de Paris and the French Society of Rheumatology played no role in each of the following: design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript. Grant support: Contrat de Recherche et d'Innovation Clinique (CRIC) from Assistance Publique–Hôpitaux de Paris (CRC 99241, P000203). Grant from the French Society of Rheumatology.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the CCPPRB Groupe Hospitalo-Universitaire Pitié-Salpêtrière, Paris, France.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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