Home training with or without joint mobilization compared to no treatment: a randomized controlled trial.
Anna Eliason, Suzanne Werner, Björn Engström and 1 others
PMID 35221520WHAT IT FOUND
Home training with or without joint mobilization did not improve overall shoulder function significantly more than no treatment over 6 months.
However, both active groups reported significantly less pain during movement compared to the reference group, with the mobilization group showing the most pain reduction.
Key findings
01There was no significant difference in total shoulder function (Constant-Murley score) between home training, home training with joint mobilization, or no treatment at any time point.
02Both home training groups reported significantly less pain during active movement (flexion, abduction, rotation) at 12 weeks and 6 months compared to the no-treatment reference group.
03The group receiving joint mobilization as an add-on to home training reached a clinically important change in function at 12 weeks, unlike the home-training-only group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The reference group was not randomized but taken from a previous study, which introduces potential bias. Group sizes were uneven (20 vs 30 vs 39) due to the randomization method used. The study excluded patients with full-thickness rotator cuff tears and those who had received corticosteroid injections, limiting generalizability to these common SAPS presentations. Compliance with home training was self-reported and high, but the study could not fully control for patients in the reference group engaging in their own exercises. The primary outcome (total C-M score) did not show differences between groups, so the findings on pain and clinical importance rely on secondary or subgroup analyses.
Declared interests
No funding sources or conflicts of interest were reported.
The easy way to misread this
Do not conclude that joint mobilization is superior to home training for overall shoulder function. The primary outcome showed no significant difference between any group, including the no-treatment reference, for total function scores. The benefit of mobilization was seen primarily in pain reduction and reaching a clinical importance threshold earlier, not in superior long-term functional outcomes compared to exercise alone.