Effects of Movement Representation Techniques with Sensorimotor Training for Rotator Cuff Related Shoulder Pain

Effects of Movement Representation Techniques with Sensorimotor Training for Rotator Cuff Related Shoulder Pain: a Randomised Controlled Trial

The aim of this study is to evaluate the efficacy of 12 weeks of sensorimotor training with movement representation techniques for reducing pain intensity in people with rotator cuff related shoulder pain, relative to standard care. Besides, the secondary aim of this study is to explore the mechanisms underlying the effects of central mechanism treatment in people with rotator cuff related shoulder pain. A total of 122 older adults aged 50 or above with the presence of shoulder pain for more than three months will be recruited and randomized into 12-weeks of movement representation techniques with sensorimotor training vs. standard care. Shoulder pain and disability Index (SPADI), changes in primary motor cortex (M1) using brain MRI, changes in subacromial space using ultrasound imaging, Widespread Pain Index (WPI), Pain Catastrophising Scale (PCS), and Fear-avoidance Beliefs questionnaires (FABQ) will be assessed at baseline and 12-week post intervention.

Inclusion Criteria:

• Aged 50 or above
• Presence of shoulder pain for more than three months
• Clinical test showed 3/5 positive tests (painful arc, resisted external rotation, Neer test, Kennedy-Hawkins test, and Jobe test), and the intensity of pain being provoked should be ≥ 3/10 on an 11-point numeric pain rating scale (NPRS)
• Structural changes of rotator cuff tendons using MRI or ultrasound imaging

Exclusion Criteria:

• History of trauma
• Shoulder fracture, glenohumeral osteoarthritis, or arthritis in the acromioclavicular joint
• Clinically suspected labrum lesion
• Previous shoulder surgery or dislocation
• Clinical signs of anterior shoulder instability
• Clinical signs of frozen shoulders
• Previous clinical treatment or corticosteroid injection for a shoulder injury within the last 12 months
• Symptoms referred from or related to the spine; and (9) other competing diagnoses (i.e., rheumatoid arthritis, cancer, neurological disorders, fibromyalgia, or psychiatric illness).