Administrative information
Title {1} | Efficacy of five-step shoulder manipulation for rotator cuff-related shoulder pain: protocol for a multicenter randomized controlled trial |
Trial registration {2a and 2b} | China Registered Clinical Trial Registration Center ChiCTR2000037577. Registered on 29 August 2020 and updated on July 18 2022. Details of the trial registration are shown in Supplementary Table 1 |
Protocol version {3} | Protocol version 2.0, June 19, 2022 |
Funding {4} | Medical Innovation Project of Shanghai Science and Technology Commission (No. 21Y11921300). Domestic Science and Technology Cooperation Project of Shanghai Science and Technology Innovation Action Plan (No. 22015830700). Shanghai University of TCM Excellent Talents Training Program (TCM[2020]10) and Xinglin Young Talent Training System-Xinglin Scholars Project (TCM[2020]23). Future plans of Shanghai Municipal Hospital of TCM (No. WLJH2021ZY-ZLZX001, GZS001, MZY034) |
Author details {5a} | Shuang Liu: Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine; Institute of Spinal Disease, LongHua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Jintao Liu: Department of Orthopaedics, Suzhou Hospital of Traditional Chinese Medicine Lin Chen: Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine Tianyou Fan: Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine Xuejun Cui: Institute of Spinal Disease, LongHua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Shaodan Cheng: Department of Rehabilitation, Shanghai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine Yanjiao Chen: Shanghai Research Institute of Acupuncture and Meridian, YueYang Hospital of Integrated Traditional Chinese and Western Medicine Qi Shi: Institute of Spinal Disease, LongHua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Qi Shi’s Studio of Famous Chinese Medicine Physician Chunchun Xue: Department of Pain, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine Xiaofeng Li: Department of Orthopedics, Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine; Qi Shi’s Studio of Famous Chinese Medicine Physician |
Name and contact information for the trial sponsor {5b} | Xiaofeng Li, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China. E-mail: lixiaofeng0409@163.com |
Role of sponsor {5c} | The study sponsor will designate relevant researchers to conduct the study, collect, manage and analyze the data, and publish the results in a peer-reviewed journal. Funders do not participate in this study |
Introduction
Background and rationale {6a}
Objectives {7}
Trial design {8}
Methods: participants, interventions, and outcomes
Study setting {9}
Eligibility criteria {10}
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✧ Age 40–70 years old;
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✧ Pain in the anterolateral acromial area or pain with active shoulder elevation [12], with symptoms lasting for more than 3 months;
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✧ Positive signs in each of the following 4 categories: pain when resisting humeral external rotation or abduction, Jobe test, Hawkins test, Neer test;
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✧ VAS score ≥ 40 mm.
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✧ Glenohumeral osteoarthritis (OA) or other inflammatory arthritis;
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✧ Frozen shoulder;
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✧ Fracture or dislocation of shoulder;
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✧ Previous neck or shoulder surgery;
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✧ Osteoporosis;
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✧ Neurological disorders;
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✧ Tumor;
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✧ Pregnancy.
Who will take informed consent? {26a}
Additional consent provisions for collection and use of participant data and biological specimens {26b}
Interventions
Explanation for the choice of comparators {6b}
Intervention description {11a}
Five-step shoulder manipulation
Sham manipulation
Home-based exercise
Weeks 1–6: exercises (1), (2), (3), (4), and (5)
Weeks 7–12: exercises (1), (6), (7), (8), and (9)
Criteria for discontinuing or modifying allocated interventions {11b}
Strategies to improve adherence to interventions {11c}
Relevant concomitant care permitted or prohibited during the trial {11d}
Provisions for post-trial care {30}
Outcomes {12}
Primary outcome | Secondary outcomes | |||
---|---|---|---|---|
Outcome measure | Shoulder function | Shoulder pain | Shoulder range of motion | Quality of life |
Method of measurement | Constant-Murley Score [16] | Visual analog scale [17] | Active range of movement of shoulder joint [18] | The 36-Item Short Form Survey [19] |
Analysis metric and method of aggregation | Difference in the mean of change from baseline between the two groups | |||
Time point | 4, 12, 18, and 24 weeks. The principal analysis will be performed at 4 and 12 weeks | 4, 12, 18, and 24 weeks |
Primary outcome
CMS
Secondary outcomes
VAS
ROM
SF-36
Participant timeline {13}
Sample size {14}
Recruitment {15}
Assignment of interventions: allocation
Sequence generation {16a}
Concealment mechanism {16b}
Implementation {16c}
Assignment of interventions: blinding
Who will be blinded {17a}
Procedure for unblinding if needed {17b}
Data collection and management
Plans for assessment and collection of outcomes {18a}
Plans to promote participant retention and complete follow-up {18b}
Data management {19}
Confidentiality {27}
Plans for collection, laboratory evaluation, and storage of biological specimens for genetic or molecular analysis in this trial/future use {33}
Statistical methods
Statistical methods for primary and secondary outcomes {20a}
Variable/outcome | Outcome measure | Methods of analysis |
---|---|---|
1) Primary | ||
The mean of change in shoulder function from baseline to 4, 12, 18, and 24 weeks | Constant-Murley score (continuous) | T-test or Mann–Whitney U-testa |
2) Secondary | ||
The mean of change in shoulder pain from baseline to 4, 12, 18, and 24 weeks | Visual analogue scale (continuous) | T-test or Mann–Whitney U-testa |
The mean of change in shoulder range of motion from baseline to 4, 12, 18, and 24 weeks | Active range of movement of shoulder joint (continuous) | T-test or Mann–Whitney U-testa |
The mean of change in quality of life from baseline to 4, 12, 18, and 24 weeks | The 36-Item Short Form Survey (continuous) | T-test or Mann–Whitney U-testa |