Apprehension-based Training Compared With Standard Physical Therapy for Military Personnel Following Anterior Shoulder Dislocation - a Randomized Clinical Trial

Apprehension-based Training Compared With Standard Physical Therapy Among Military Personnel Following Anterior Shoulder Dislocation

The goal of this clinical trial is to determine if a new rehabilitation protocol (apprehension-based training), leads to better recovery after shoulder dislocation among military personnel.

Participants will be randomly allocated to apprehension-based training or standard physical therapy. In apprehension-based training participants will train to control their shoulder under progressively more unstable conditions. Standard physical therapy will be provided based on the clinical judgment of the treating physical therapist The primary hypothesis is that participants undergoing apprehension-based training will experience a more complete recovery of function, better shoulder-related quality of life, and incur less recurrent dislocations.

Inclusion Criteria:

• Age 18-39 years
• Shoulder dislocation (primary or recurrent) documented by a medical practitioner (physician, military medic)
• Positive anterior apprehension test
• Gross shoulder muscle strength 3/5 or greater

Exclusion Criteria:

• Previous shoulder fracture, tendon tear, or shoulder surgery
• Voluntary shoulder dislocation
• Functional (Stanmore polar III) shoulder instability
• Dislocation associated with a motor vehicle accident.
• Diagnosis of rheumatoid arthritis, cancer (current), fibromyalgia, psychiatric disease)
• Current pregnancy
• Inability to attend at least one physical therapy session every 2 weeks.