Abstract | BACKGROUND: OBJECTIVE: To compare the effectiveness of 2 common nonsurgical treatments for SIS. DESIGN: Randomized, single-blind, comparative-effectiveness, parallel-group trial. (ClinicalTrials.gov: NCT01190891). SETTING: Military hospital-based outpatient clinic in the United States. PATIENTS: 104 patients aged 18 to 65 years with unilateral SIS between June 2010 and March 2012. INTERVENTION: MEASUREMENTS: The primary outcome was change in Shoulder Pain and Disability Index scores at 1 year. Secondary outcomes included the Global Rating of Change scores, the Numeric Pain Rating Scale scores, and 1-year health care use. RESULTS: Both groups demonstrated approximately 50% improvement in Shoulder Pain and Disability Index scores maintained through 1 year; however, the mean difference between groups was not significant (1.5% [95% CI, -6.3% to 9.4%]). Both groups showed improvements in Global Rating of Change scale and pain rating scores, but between-group differences in scores for the Global Rating of Change scale (0 [CI, -2 to 1]) and pain rating (0.4 [CI, -0.5 to 1.2]) were not significant. During the 1-year follow-up, patients receiving CSI had more SIS-related visits to their primary care provider (60% vs. 37%) and required additional steroid injections (38% vs. 20%), and 19% needed physical therapy. Transient pain from the CSI was the only adverse event reported. LIMITATION: CONCLUSION: Both groups experienced significant improvement. The manual physical therapy group used less 1-year SIS-related health care resources than the CSI group. PRIMARY FUNDING SOURCE: Cardon Rehabilitation Products through the American Academy of Orthopaedic Manual Physical Therapists.
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Authors | Daniel I Rhon, Robert B Boyles, Joshua A Cleland |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 161
Issue 3
Pg. 161-9
(Aug 05 2014)
ISSN: 1539-3704 [Electronic] United States |
PMID | 25089860
(Publication Type: Comparative Study, Journal Article, Pragmatic Clinical Trial, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Inflammatory Agents
- Triamcinolone Acetonide
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Topics |
- Adolescent
- Adult
- Aged
- Anti-Inflammatory Agents
(therapeutic use)
- Female
- Humans
- Injections, Intra-Articular
- Male
- Middle Aged
- Physical Therapy Modalities
- Shoulder Impingement Syndrome
(drug therapy, therapy)
- Single-Blind Method
- Treatment Outcome
- Triamcinolone Acetonide
(therapeutic use)
- Young Adult
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