title: Does passive mobilization of shoulder region joints provide additional benefit over advice and exercise alone for people who have shoulder pain and minimal movement restriction? A randomized controlled trial.
abstract: BACKGROUND
  Passive mobilization of shoulder region joints, often in conjunction with other treatment modalities, is used for the treatment of people with shoulder pain and minimal movement restriction. However, there is only limited evidence supporting the efficacy of this treatment modality.
  
  
  OBJECTIVE
  The purpose of this study was to determine whether passive mobilization of shoulder region joints adds treatment benefit over exercise and advice alone for people with shoulder pain and minimal movement restriction.
  
  
  METHODS
  This was a randomized controlled clinical trial with short-, medium- and longer-term follow-up.
  
  
  METHODS
  The study was conducted in a metropolitan teaching hospital.
  
  
  METHODS
  Ninety-eight patients with shoulder pain of local mechanical origin and minimal shoulder movement restriction were randomly allocated to either a control group (n=51) or an experimental group (n=47).
  
  
  METHODS
  Participants in both groups received advice and exercises designed to restore neuromuscular control at the shoulder. In addition, participants in the experimental group received passive mobilization specifically applied to shoulder region joints.
  
  
  METHODS
  Outcome measurements of shoulder pain and functional impairment, self-rated change in symptoms, and painful shoulder range of motion were obtained at 1, 3, and 6 months after entry into the trial. All data were analyzed using the intention-to-treat principle by repeated-measures analyses of covariance.
  
  
  RESULTS
  No statistically significant differences were detected in any of the outcome measurements between the control and experimental groups at short-, medium-, or longer-term follow-up.
  
  
  CONCLUSIONS
  Therapists and participants were not blinded to the treatment allocation.
  
  
  CONCLUSIONS
  This randomized controlled clinical trial does not provide evidence that the addition of passive mobilization, applied to shoulder region joints, to exercise and advice is more effective than exercise and advice alone in the treatment of people with shoulder pain and minimal movement restriction.
authors.affiliation: Discipline of Physiotherapy, Faculty of Health Sciences, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Ross
authors.initials: R
authors.lastname: Yiasemides
authors.forename: Mark
authors.initials: M
authors.lastname: Halaki
authors.forename: Ian
authors.initials: I
authors.lastname: Cathers
authors.forename: Karen A
authors.initials: KA
authors.lastname: Ginn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010353:Patient Education as Topic; D016059:Range of Motion, Articular / Q000502:physiology; D020069:Shoulder Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome