title: Mobilization With Movement for Shoulder Dysfunction in Older Adults: A Pilot Trial.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the feasibility of the methods proposed to conduct a full randomized clinical trial to assess the effectiveness of mobilization with movement on shoulder functionality in older adults with shoulder dysfunction.
  
  
  METHODS
  A pilot, randomized, single-blinded clinical trial was carried out with 44 older adults (83.9±8.2 years) with shoulder dysfunction in 3 nursing homes in Toledo, Spain. Participants were recruited through information sessions and were randomly allocated into 2 groups. The control group (n = 22) intervention consisted of a physical therapy standard protocol proposed by the Spanish Rheumatology Society. Techniques based on Mulligan's concepts of mobilization with movement were added to the standard protocol for the experimental group (n = 22) intervention. Interventions took place 3 times a week for 2 consecutive weeks and were performed by 2 experienced therapists. Main outcomes were recruitment rates, participation and adherence to interventions, assessment procedures, and the implementation of mobilization with movement. Clinical outcomes were shoulder functionality, active glenohumeral range of motion, and pain intensity. Data were collected at baseline, after each group intervention, and at 1 and 3 months after finishing interventions.
  
  
  RESULTS
  All the participants accepted to be randomized. Participation rates were 97.7% for the experimental group and 95.5% for the control group. The analysis of variance did not show any statistically significant difference between treatment groups for any of the variables (all P values for the group effect were greater than .36) or a change of the difference between groups over time (all P values for the time-treatment interactions were greater than .3).
  
  
  CONCLUSIONS
  The research methods tested in this pilot study offer a suitable foundation to conduct a full clinical trial.
authors.affiliation: Physiotherapist, State Center of Attention to Brain Injury, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Lirio Romero
authors.affiliation: Professor, University of Alcalá, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Torres Lacomba
authors.affiliation: Physiotherapist, Rio Riansares Nursing Home, Corral de Almaguer, Toledo, Spain.
authors.forename: Yurema
authors.initials: Y
authors.lastname: Castilla Montoro
authors.affiliation: Lecturer, Clinical Trial Unit, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Prieto Merino
authors.affiliation: Professor, University of Alcalá, Madrid, Spain.
authors.forename: Soraya
authors.initials: S
authors.lastname: Pacheco da Costa
authors.affiliation: Occupational Therapist, Messengers of Peace Association, Golden Age, Toledo, Spain.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Velasco Marchante
authors.affiliation: Physiotherapist, Private Practice, Madrid, Spain.
authors.forename: Gema
authors.initials: G
authors.lastname: Bodes Pardo
keywords: Disability evaluation; Frail elderly; Physical therapy modalities; Shoulder