Passive mobilisation of shoulder region joints plus advice and exercise does not reduce pain and disability more than advice and exercise alone: a randomised trial.

QUESTION Is the addition of passive mobilisation of shoulder region joints to advice and exercise for patients with shoulder pain and stiffness more effective than advice and exercise alone? DESIGN Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS 90 people who had shoulder pain and stiffness for more than one month. INTERVENTION All participants received advice and exercise. The experimental group also received passive joint mobilisation of shoulder region joints. OUTCOME MEASURES Primary outcome measures included pain and disability measured with the 13-point Shoulder Pain and Disability Index. Secondary outcome measures were self-perceived global improvement measured on a 6-point scale and active ranges of motion. Subjects received a maximum of 10 sessions of therapy. Outcome measurements were taken at baseline, one month, and six months. RESULTS The experimental group had 3% (95% CI -5 to 11) less pain and disability than the control group at one month and 1% (95% CI -13 to 16) less pain at six months, which are statistically nonsignificant. Their global perceived effect was 0.1 out of 5 (95% CI -0.2 to 0.4) worse than the control group at one month and 0.1 (95% CI -0.5 to 0.7) better at 6 months, which are also statistically non-significant. Differences between groups in all range of motion measures were small and statistically non-significant. CONCLUSION The addition of passive joint mobilisation of shoulder region joints is not more effective than advice and exercise alone for shoulder pain and stiffness. TRIAL REGISTRATION ACTRN 12605000080628.