Cognitive Functional Therapy for Treating Individuals With Chronic Shoulder Pain

ConditionsChronic Shoulder Pain Exercise Therapy Psychosocial Rehabilitation

Trial statusRecruiting

Trial phaseNot applicable

Trial typeInterventional

Biological sexAll

Age18-60

SponsorFederal University of Paraíba

About this trial

Shoulder pain is a debilitating musculoskeletal condition with functional, physical, and psychological impacts. Interventions for chronic shoulder pain should address the biopsychosocial model, with Cognitive Functional Therapy emerging as a promising physiotherapy approach. Cognitive Functional Therapy approaches the multidimensional nature of pain, integrating physical and cognitive aspects.

The aim of this randomized controlled trial is to compare the effects of Cognitive Functional Therapy with therapeutic exercise on biological aspects of pain (pain intensity, disability, function, perception of improvement/deterioration, and central pain processing), and psychosocial aspects of pain (sleep quality, self-efficacy, and biopsychosocial factors). The hypothesis of this study is that CFT will lead to greater improvements in these outcomes compared to therapeutic exercise.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Men or women;

Age between 18 and 60 years;

Presence of shoulder pain for more than 3 months;

Pain intensity of 4 points or more on the 11-point Numeric Pain Rating Scale.

Disqualifiers

History of fracture or surgery of the clavicle, scapula, and/or humerus, surgical stabilization or rotator cuff repair;

History of dislocation, instability (positive sulcus sign or apprehension test), and/or rotator cuff tear (positive drop arm test);

Adhesive capsulitis verified by the presence of gradual onset pain associated with stiffness and reduced passive and active mobility;

Ongoing pregnancy;

Trial design

Design model

Parallel

Treatments tested in this trial

Cognitive Functional Therapy (CFT)
Behavioral
Cognitive Functional Therapy (CFT) is underpinned by a strong therapeutic alliance, active listening, and motivational interviewing style, covering the following domains: i) Making sense of pain involves discussing the multidimensional nature of persistent pain, as well as the beliefs, emotions, and behaviors that can perpetuate the vicious cycle of pain and disability. ii) Exposure with control involves a functional training designed to normalize maladaptive and provocative postural and movement behaviors, where individuals will learn strategies to improve their body awareness and control and modify postures and tasks commonly associated with pain. iii) Lifestyle change aims to help patients embrace a healthy lifestyle, which will include promoting a gradual increase in physical activity, sleep hygiene counseling, stress management strategies, and social re-engagement.
Therapeutic exercises group
Other intervention
Each session will include stretching exercises targeting the following muscles i) Upper trapezius; ii) Pectoralis minor; iii) Posterior shoulder region, and strengthening exercises targeting the following muscles i) Lower trapezius, ii) Middle trapezius, iii) Serratus punch exercise, iv) Shoulder external rotators, and v) Shoulder internal rotators.

Treatment groups

72 Participants

are divided into 2 treatment groups

Group A: Cognitive Functional TherapyExperimental treatment 1 intervention

Group B: Therapeutic exercises groupActive comparator 1 intervention

Trial outcomes

Primary outcomes

Pain intensity: Numerical Pain Rating Scale (NPRS)

The pain intensity will be measured with 11 point - Numerical Rating Pain Scale (NPRS) with scores ranging from 0 (no pain) to 10 (maximum pain). Higher scores indicate greater pain intensity.

Time frame