Scientific summary:
What were the main scientific objectives of the grant?
The primary scientific objectives of the grant were to assess the feasibility of a fully powered, multicentre randomized controlled trial comparing the efficacy of high load-volume versus low load-volume exercise interventions for rotator cuff tendinopathy.
Specifically, the study aimed to evaluate the recruitment rate, retention rate, adherence to the prescribed exercise regimen, and completion rate of follow-up questionnaires. Additionally, the study sought to compare the clinical outcomes between the two exercise interventions, focusing on shoulder pain and disability index (SPADI), pain intensity (visual analogue scale), and one repetition maximum (1RM) strength measurements.
The research aimed to identify the most effective exercise variables for treating rotator cuff tendinopathy and to ensure the safety and tolerability of the interventions.
What were the main scientific achievements of the grant?
The trial provided valuable data on the adherence rates and retention of participants over a 26-week period. The retention rates were 83.9% at 6 weeks and 80.6% at both 12 and 26 weeks, indicating strong participant engagement throughout the study. Additionally, the completion rates for follow-up questionnaires were relatively high, although slightly below the predefined success criteria.
Clinically, both high load-volume and low load-volume exercise interventions led to improvements in shoulder pain and function, as measured by SPADI and visual analogue scale scores. Notably, the high load-volume group exhibited greater gains in 1RM strength tests, suggesting that higher intensity exercises may be more effective for enhancing strength in individuals with rotator cuff tendinopathy.
However, the study also identified challenges, such as slightly lower adherence rates to the prescribed exercise regimens and increased reports of shoulder pain requiring additional analgesia in the high load-volume group. These findings suggest the need for improved methods to monitor and support exercise adherence.
Overall, these outcomes lay the groundwork for future research aimed at optimizing rehabilitation strategies for rotator cuff tendinopathy.
What problems, if any, did you encounter in achieving the project’s objectives, and how did you address them?
There were no issues outside of the usual challenges encountered in running a randomised trial
What is the plan for dissemination of findings?
The findings have been included within a PhD thesis and are now under review for publication in a peer reviewed scientific journal.
Lay summary:
Overview:
This study looked at how different exercise programs can help people with rotator cuff tendinopathy, a common shoulder problem causing pain and difficulty in moving. We wanted to find out if doing exercises with weights is better than doing the same exercises without weights.
We asked 31 people with shoulder pain to join our study. They were split into two groups: one group did exercises using dumbbells, and the other group did the exercises without any added weight. They followed these exercise plans for 12 weeks, with up to seven sessions guided by a physiotherapist.
We wanted to see if we could successfully run a larger study comparing these two types of exercise programs. We aimed to learn how well people would stick to the exercise plan and how it would affect their shoulder pain and strength.
Most people completed their exercises and filled out the follow-up questionnaires. Both groups saw improvements in their shoulder pain and function, but those who used weights got stronger. Overall, our study shows it’s possible to run a bigger trial to compare these exercise programs. Future studies should find ways to help people stick to their exercises and manage any pain they might feel. This research helps us understand how different exercise types can improve shoulder pain and strength.
What problems did you try to solve, or gaps in knowledge did you try to fill?
The study aimed to answer whether high load-volume exercises (using weights) are more effective than low load-volume exercises (no weights) for treating rotator cuff tendinopathy. We sought to solve the problem of unclear exercise guidelines by comparing the two exercise intensities. This is important because rotator cuff tendinopathy affects many people, causing long-term pain and disability, and exercise is a key treatment. By identifying the most effective exercise approach, we can improve rehabilitation strategies, reduce pain and disability, and enhance the quality of life for those affected by this common shoulder condition.
What did you discover during the course of the grant?
During the study, we discovered that using social media for recruitment was highly effective, allowing us to enroll 31 participants in just two months. This success suggests that similar methods could be used for larger studies. Both high load-volume (using weights) and low load-volume (no weights) exercise programs improved shoulder pain and function. However, the group using weights saw greater strength gains, indicating that higher intensity exercise may be more beneficial for building strength.
We also found that adherence to the exercise programs was slightly below our target, particularly in the high load-volume group. Some participants in this group experienced increased shoulder pain, requiring extra pain relief.
Participant retention and questionnaire completion rates were high, showing strong engagement throughout the study. These findings suggest that a larger trial is feasible and can provide valuable insights into the best exercise practices for treating rotator cuff tendinopathy. Overall, our pilot trial demonstrated the potential benefits of different exercise intensities and provided important information for future research and clinical applications.
Have the findings of the research already benefited people with musculoskeletal disease? How might the findings inform further research to help sufferers in the future?
The findings have not yet directly benefited people with musculoskeletal disease but provide a foundation for future studies. This research informs further trials by highlighting the importance of exercise intensity and adherence. Future research can build on these insights to develop more effective, personalized rehabilitation programs, ultimately improving outcomes for those with rotator cuff tendinopathy.
Are you planning to continue the research?
We are cautious about moving to a full-scale trial due to the limited differences in pain benefits between the groups. The next steps involve rethinking the study design to address adherence issues. Our team is currently working in technology that can measure how much exercise people do more accurately which could be used in a future trial to more accurately assess the relationship between exercise and patient benefit.