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Shoulder DislocationNCT05767957

Contribution Of Cognitivo-Behavorial Therapy In Shoulder Apprehension

A study testing Rehabilitation physiotherapy and Cognitive-behavioral therapies in addition to rehabilitation physiotherapy in people with Shoulder Dislocation and Shoulder Instability, run by Centre Epaule Coude CEPCO at 2 sites in Switzerland.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Randomized controlled double-blind study aimed at studying the contribution of cognitive-behavioral therapy in the treatment of shoulder apprehension. Comparison of 2 physiotherapy techniques in the context of shoulder instability. Read more about this study

Who is it for?
Ages 15 to 45 years
Conditions the study is for
Shoulder Dislocation, Shoulder Instability
What is being tested?
Rehabilitation physiotherapy and Cognitive-behavioral therapies in addition to rehabilitation physiotherapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
144 participants
Where
2 sitesSwitzerland
Study dates
1 Jan 2022to 31 Dec 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 to 45 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • positive apprehension test;
  • traumatic anterior dislocation of the glenohumeral joint requiring or not surgical stabilization according to Bankart or Latarjet;
  • good oral and written comprehension of French;
  • age between 15 and 45 years old.

Who cannot join

  • associated tendon injury requiring surgical treatment;
  • fracture other than Bankart fracture;
  • multidirectional instability (MDI);
  • peripheral neurological lesion in the upper limb;
  • central neurological lesion;
  • diagnosed psychosis, depression or epilepsy.

Trial locations and contacts

2 sites in 1 country.

Switzerland2 sites, 2 recruiting
  • Centre Epaule Coude CEPCO

    Geneva, 1206

    Benoît Borner, +41 79 430 17 26, benoit.borner@bluewin.ch

    Benoît Borner

    Recruiting
  • Hôpital La Tour

    Meyrin, 1217

    Benoît Borner, +41 79 430 17 26, benoit.borner@bluewin.ch

    Alexandre Laedermann

    Recruiting

Other trials in Switzerland

About this study

Official title: The Contribution Of Cognitivo-Behavorial Therapy In Treatment Of Shoulder Apprehension: A Randomized Clinical Study

Randomized controlled double-blind study aimed at studying the contribution of cognitive-behavioral therapy in the treatment of shoulder apprehension. Comparison of 2 physiotherapy techniques in the context of shoulder instability.

Control group: rehabilitation physiotherapy by physiotherapist using conventional technique alone.

Intervention group: rehabilitation physiotherapy by physiotherapist according to conventional technique, with the addition of techniques from cognitive-behavioral therapies.

Read the detailed description

Traumatic anterior instability of the shoulder is one of the most frequent lesions of the shoulder, the majority of cases of which occur in adolescents, with a risk of recurrence close to 90% if it occurs before the age of 20 years. It can be treated conservatively or surgically. Stabilizing surgery of the glenohumeral joint offers satisfactory results for people suffering from shoulder instability. Like subjects treated conservatively, patients undergoing stabilizing surgery remain apprehensive after the operation in 2 to 51% of cases. Currently, no rehabilitation program has demonstrated superior effectiveness, during instability treated conservatively or during postoperative rehabilitation. Recent studies have shown that cortical reorganization takes place, especially in areas of fear and anxiety. Faced with the need to develop physiotherapeutic management in post-traumatic unstable shoulder, this study aims to evaluate the contribution of cognitive-behavioral therapy, by including a neuropsychological axis in the rehabilitation of patients.

This study is randomized and controlled, multicenter, including 144 patients suffering from apprehension of the shoulder, divided into two treatment groups. Both groups will receive a conventional physiotherapy protocol including individual sessions and home exercises. The physiotherapists in the intervention group will also have received training in the use of techniques from Cognitive-Behavioral Therapies. Data will be collected before the introduction of physiotherapy, after 6, 12, 24 and 52 weeks of treatment. In the event of surgery, the data will also be collected preoperatively. The primary outcome is apprehension measured by the Rowe score. The secondary outcomes are apprehension measured by the apprehension and relocation tests, and the Tampa Scale for Kinesiophobia, as well as shoulder function, measured by the Simple Shoulder Test and the Subjective Shoulder Value.

Being tested
Rehabilitation physiotherapy, Cognitive-behavioral therapies in addition to rehabilitation physiotherapy
Medical subject headings
Shoulder Dislocation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Rehabilitation physiotherapyOther

    Rehabilitation physiotherapy by physiotherapist using conventional technique alone.

  • Cognitive-behavioral therapies in addition to rehabilitation physiotherapyOther

    Rehabilitation physiotherapy by physiotherapist according to conventional technique, with the addition of techniques from cognitive-behavioral therapies.

Study groups in NCT05767957
Study groupRoleWhat they receive
Control groupActive comparatorNot described
Receives: Other: Rehabilitation physiotherapy
Intervention groupExperimentalNot described
Receives: Other: Cognitive-behavioral therapies in addition to rehabilitation physiotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rowe score

    Score for Shoulder Stability; 0-100 points (excellent: 90-100 pts; good: 75-89 pts; average: 51-74 pts; bad: <50 pts)

    Measured: enrolment

  2. Rowe score

    Score for Shoulder Stability; 0-100 points (excellent: 90-100 pts; good: 75-89 pts; average: 51-74 pts; bad: <50 pts)

    Measured: 6 weeks

  3. Rowe score

    Score for Shoulder Stability; 0-100 points (excellent: 90-100 pts; good: 75-89 pts; average: 51-74 pts; bad: <50 pts)

    Measured: 3 months

  4. Rowe score

    Score for Shoulder Stability; 0-100 points (excellent: 90-100 pts; good: 75-89 pts; average: 51-74 pts; bad: <50 pts)

    Measured: 6 months

  5. Rowe score

    Score for Shoulder Stability; 0-100 points (excellent: 90-100 pts; good: 75-89 pts; average: 51-74 pts; bad: <50 pts)

    Measured: 12 months

Secondary outcomes (40)
  1. Shoulder Range Of Motion: flexion

    unit of measure: angle 0-180° degrees (worst: 0°; best: 180°); measurement tool: goniometer

    Measured: enrolment

  2. Shoulder Range Of Motion: flexion

    unit of measure: angle 0-180° degrees (worst: 0°; best: 180°); measurement tool: goniometer

    Measured: 3 months

  3. Shoulder Range Of Motion: flexion

    unit of measure: angle 0-180° degrees (worst: 0°; best: 180°); measurement tool: goniometer

    Measured: 6 months

  4. Shoulder Range Of Motion: flexion

    unit of measure: angle 0-180° degrees (worst: 0°; best: 180°); measurement tool: goniometer

    Measured: 12 months

  5. Shoulder Range Of Motion: abduction

    unit of measure: angle 0-180° degrees (worst: 0°; best: 180°); measurement tool: goniometer

    Measured: enrolment

  6. Shoulder Range Of Motion: abduction

    unit of measure: angle 0-180° degrees (worst: 0°; best: 180°); measurement tool: goniometer

    Measured: 3 months

  7. Shoulder Range Of Motion: abduction

    unit of measure: angle 0-180° degrees (worst: 0°; best: 180°); measurement tool: goniometer

    Measured: 6 months

  8. Shoulder Range Of Motion: abduction

    unit of measure: angle 0-180° degrees (worst: 0°; best: 180°); measurement tool: goniometer

    Measured: 12 months

  9. Shoulder Range Of Motion: external rotation

    unit of measure: angle 0-90° degrees (worst: 0°; best: 90°); measurement tool: goniometer

    Measured: enrolment

  10. Shoulder Range Of Motion: external rotation

    unit of measure: angle 0-90° degrees (worst: 0°; best: 90°); measurement tool: goniometer

    Measured: 3 months

  11. Shoulder Range Of Motion: external rotation

    unit of measure: angle 0-90° degrees (worst: 0°; best: 90°); measurement tool: goniometer

    Measured: 6 months

  12. Shoulder Range Of Motion: external rotation

    unit of measure: angle 0-90° degrees (worst: 0°; best: 90°); measurement tool: goniometer

    Measured: 12 months

  13. Shoulder Range Of Motion: internal rotation

    unit of measure: height of the position of the hand in the back according to anatomical landmarks; 1- lateral thigh, 2- buttock, 3- lumbosacral junction, 4- waist (L3 vertebra), 5- T12 vertebra, 6- interscapular (T7 vertebra) (worst: 1; best: 6)

    Measured: enrolment

  14. Shoulder Range Of Motion: internal rotation

    unit of measure: height of the position of the hand in the back according to anatomical landmarks; 1- lateral thigh, 2- buttock, 3- lumbosacral junction, 4- waist (L3 vertebra), 5- T12 vertebra, 6- interscapular (T7 vertebra) (worst: 1; best: 6)

    Measured: 3 months

  15. Shoulder Range Of Motion: internal rotation

    unit of measure: height of the position of the hand in the back according to anatomical landmarks; 1- lateral thigh, 2- buttock, 3- lumbosacral junction, 4- waist (L3 vertebra), 5- T12 vertebra, 6- interscapular (T7 vertebra) (worst: 1; best: 6)

    Measured: 6 months

  16. Shoulder Range Of Motion: internal rotation

    unit of measure: height of the position of the hand in the back according to anatomical landmarks; 1- lateral thigh, 2- buttock, 3- lumbosacral junction, 4- waist (L3 vertebra), 5- T12 vertebra, 6- interscapular (T7 vertebra) (worst: 1; best: 6)

    Measured: 12 months

  17. Rotator cuff strength: anterior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: enrolment

  18. Rotator cuff strength: anterior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: 3 months

  19. Rotator cuff strength: anterior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: 6 months

  20. Rotator cuff strength: anterior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: 12 months

  21. Rotator cuff strength: superior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: enrolment

  22. Rotator cuff strength: superior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: 3 months

  23. Rotator cuff strength: superior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: 6 months

  24. Rotator cuff strength: superior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: 12 months

  25. Rotator cuff strength: posterior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: enrolment

  26. Rotator cuff strength: posterior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: 3 months

  27. Rotator cuff strength: posterior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: 6 months

  28. Rotator cuff strength: posterior cuff

    scale 0-5 (0/5: no contraction ; 1/5: muscle contraction visible, no motion; 2/5: motion with gravity eliminated; 3/5: motion against gravity; 4/5: motion against moderate resistance; 5/5: normal muscle strength)

    Measured: 12 months

  29. Apprehension test

    examiner flexes the patient's elbow to 90° and abducts shoulder to 90°, then slowly externally rotates the patient's shoulder; the patient demonstrates apprehension during shoulder external rotation at different positions as follow: 1- early, 2- cocked position, 3- forced external rotation, 4- forced external rotation with posterior-anterior pressure (worst: 1; best: 4)

    Measured: enrolment

  30. Apprehension test

    examiner flexes the patient's elbow to 90° and abducts shoulder to 90°, then slowly externally rotates the patient's shoulder; the patient demonstrates apprehension during shoulder external rotation at different positions as follow: 1- early, 2- cocked position, 3- forced external rotation, 4- forced external rotation with posterior-anterior pressure (worst: 1; best: 4)

    Measured: 3 months

  31. Apprehension test

    examiner flexes the patient's elbow to 90° and abducts shoulder to 90°, then slowly externally rotates the patient's shoulder; the patient demonstrates apprehension during shoulder external rotation at different positions as follow: 1- early, 2- cocked position, 3- forced external rotation, 4- forced external rotation with posterior-anterior pressure (worst: 1; best: 4)

    Measured: 6 months

  32. Apprehension test

    examiner flexes the patient's elbow to 90° and abducts shoulder to 90°, then slowly externally rotates the patient's shoulder; the patient demonstrates apprehension during shoulder external rotation at different positions as follow: 1- early, 2- cocked position, 3- forced external rotation, 4- forced external rotation with posterior-anterior pressure (worst: 1; best: 4)

    Measured: 12 months

  33. Subjective apprehension

    scale 0-10 (0: no apprehension at all (= best outcome); 10: maximal apprehension (= worst outcome))

    Measured: enrolment

  34. Subjective apprehension

    scale 0-10 (0: no apprehension at all (= best outcome); 10: maximal apprehension (= worst outcome))

    Measured: 3 months

  35. Subjective apprehension

    scale 0-10 (0: no apprehension at all (= best outcome); 10: maximal apprehension (= worst outcome))

    Measured: 6 months

  36. Subjective apprehension

    scale 0-10 (0: no apprehension at all (= best outcome); 10: maximal apprehension (= worst outcome))

    Measured: 12 months

  37. Relocation test

    positive/negative; patient's shoulder is brought into 90° of abduction and maximal external rotation until the patient feels apprehension; examiner gives an antero-posterior (AP) directed pressure at the humeral head; test positive if fear of luxation is reduced after the AP pressure is applied

    Measured: enrolment

  38. Relocation test

    positive/negative; patient's shoulder is brought into 90° of abduction and maximal external rotation until the patient feels apprehension; examiner gives an antero-posterior (AP) directed pressure at the humeral head; test positive if fear of luxation is reduced after the AP pressure is applied

    Measured: 3 months

  39. Relocation test

    positive/negative; patient's shoulder is brought into 90° of abduction and maximal external rotation until the patient feels apprehension; examiner gives an antero-posterior (AP) directed pressure at the humeral head; test positive if fear of luxation is reduced after the AP pressure is applied

    Measured: 6 months

  40. Relocation test

    positive/negative; patient's shoulder is brought into 90° of abduction and maximal external rotation until the patient feels apprehension; examiner gives an antero-posterior (AP) directed pressure at the humeral head; test positive if fear of luxation is reduced after the AP pressure is applied

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Mar 2023
  2. Study start1 Jan 2022
  3. Primary completion31 Jan 2022
  4. Study completion31 Dec 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Control group: rehabilitation physiotherapy by physiotherapist using conventional technique alone. Intervention group: rehabilitation physiotherapy by physiotherapist according to conventional technique, with the addition of techniques from cognitive-behavioral therapies.
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
144 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05767957
Sponsor's protocol ID
2021-01912
Status last verified
Mar 2023
First submitted
25 Jul 2022
Last updated
14 Mar 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Rehabilitation physiotherapy and Cognitive-behavioral therapies in addition to rehabilitation physiotherapy in people with Shoulder Dislocation and Shoulder Instability, run by Centre Epaule Coude CEPCO at 2 sites in Switzerland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 14 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rowe score (time frame: enrolment). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Mar 2023.

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