Michael J Mueller1, Christopher J Sorensen2, Janet B McGill3, B Ruth Clark4, Catherine E Lang5, Ling Chen6, Kathryn L Bohnert2, Mary K Hastings7. 1. Program in Physical Therapy and Department of Radiology, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Blvd, St Louis, MO 63108 (USA). 2. Program in Physical Therapy, Washington University School of Medicine. 3. Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine. 4. Program in Physical Therapy and Department of Neurology, Washington University School of Medicine. 5. Program in Physical Therapy, Program in Occupational Therapy, and Department of Neurology, Washington University School of Medicine. 6. Division of Biostatistics, Washington University School of Medicine. 7. Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine.
Abstract
Background: People with diabetes are at high risk for shoulder pain, limited joint mobility, and adhesive capsulitis. Objective: The objective of this study was to evaluate the effects of a shoulder movement intervention (ShoMo) compared to a wellness intervention on the primary outcomes of active shoulder flexion and reported Shoulder Pain and Disability Index (SPADI) measured after intervention and 9 months later. Design: The design was a prospective, randomized, controlled clinical trial. Setting: The setting was a research center at an academic medical center. Participants: Fifty-two participants with type 2 diabetes and shoulder pain or limited motion were randomized to a group receiving ShoMo (N = 27; mean age = 59.3; SD = 7.0) or a group receiving wellness activities (N = 25; meanage = 57.9; SD = 7.7). Intervention: The ShoMo group received instruction in a progressive, active shoulder movement program. The wellness group received instruction in diabetes management. Measurements: Measurements were made at baseline, after 3 months of intervention, and at 6, 9, and 12 months after baseline. Results: After intervention, the ShoMo group had a 7.2-degree increase in active shoulder flexion compared with the wellness group (95% CI = 0.9-13.5°), but there was no difference at subsequent follow-ups. The ShoMo group showed a 12.7-point improvement in the SPADI score compared to the wellness group after intervention (95% CI = 1.1-24.3), which remained better than the wellness group 9 months later. Limitations: The number of participants and duration of follow-up were inadequate to determine if intervention can help to prevent future severe shoulder problems. Conclusions: A progressive shoulder movement program can have meaningful effects on active motion and symptoms in people with type 2 diabetes and mild-to-moderate shoulder symptoms, with symptom improvement lasting at least 9 months.
RCT Entities:
Background: People with diabetes are at high risk for shoulder pain, limited joint mobility, and adhesive capsulitis. Objective: The objective of this study was to evaluate the effects of a shoulder movement intervention (ShoMo) compared to a wellness intervention on the primary outcomes of active shoulder flexion and reported Shoulder Pain and Disability Index (SPADI) measured after intervention and 9 months later. Design: The design was a prospective, randomized, controlled clinical trial. Setting: The setting was a research center at an academic medical center. Participants: Fifty-two participants with type 2 diabetes and shoulder pain or limited motion were randomized to a group receiving ShoMo (N = 27; mean age = 59.3; SD = 7.0) or a group receiving wellness activities (N = 25; mean age = 57.9; SD = 7.7). Intervention: The ShoMo group received instruction in a progressive, active shoulder movement program. The wellness group received instruction in diabetes management. Measurements: Measurements were made at baseline, after 3 months of intervention, and at 6, 9, and 12 months after baseline. Results: After intervention, the ShoMo group had a 7.2-degree increase in active shoulder flexion compared with the wellness group (95% CI = 0.9-13.5°), but there was no difference at subsequent follow-ups. The ShoMo group showed a 12.7-point improvement in the SPADI score compared to the wellness group after intervention (95% CI = 1.1-24.3), which remained better than the wellness group 9 months later. Limitations: The number of participants and duration of follow-up were inadequate to determine if intervention can help to prevent future severe shoulder problems. Conclusions: A progressive shoulder movement program can have meaningful effects on active motion and symptoms in people with type 2 diabetes and mild-to-moderate shoulder symptoms, with symptom improvement lasting at least 9 months.
Authors: Kerstin Gutefeldt; Simon Lundstedt; Ingrid S M Thyberg; Margareta Bachrach-Lindström; Hans J Arnqvist; Anna Spångeus Journal: J Diabetes Res Date: 2020-03-11 Impact factor: 4.011
Authors: Mary K Hastings; Hyo-Jung Jeong; Christopher J Sorensen; Jennifer A Zellers; Ling Chen; Kathryn L Bohnert; Darrah Snozek; Michael J Mueller Journal: Foot (Edinb) Date: 2020-03-30