Development and implementation of the physiotherapy-led exercise interventions for the treatment of rotator cuff disorders for the ‘Getting it Right: Addressing Shoulder Pain’ (GRASP) trial

David J. Keene*, Hessam Soutakbar, Sally Hopewell, Peter Heine, Anju Jaggi, Chris Littlewood, Zara Hansen, Karen Barker, Willie Hamilton, Andrew J. Carr, Sarah E. Lamb

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

5 Citations (Scopus)
51 Downloads (Pure)

Abstract

Objectives: The Getting it Right: Addressing Shoulder Pain (GRASP) trial is a large-scale, multicentre, 2 × 2 factorial randomised controlled trial investigating clinical and cost-effectiveness of a progressive exercise programme versus best-practice advice, with or without corticosteroid injection, for treating people with rotator cuff disorders. Here we describe the development, implementation and details of the physiotherapy-led interventions. Methods: Medical Research Council guidance for developing complex interventions were used, taking into account clinical guidelines, expert and patient opinion, research evidence, current practice variation, and deliverability. A stakeholder meeting of 26 experts, clinicians, researchers, and patient representatives was used to design key components of the interventions. Stakeholders prioritised strengthening posterior rotator cuff muscles and using practical, easy-to-do exercises. The interventions were designed to be deliverable across the UK National Health Service. Results: Progressive exercise consists of up to six sessions with a physiotherapist over 16 weeks. The best-practice advice consists of one face-to-face session with a physiotherapist with substantially greater reliance on self-management. Both interventions include self-management advice, home-exercise instruction, and behaviour-change strategies to target exercise adherence. All participants receive a Participant Information Booklet. The best-practice advice intervention is a self-guided system of progressively challenging exercises, with demonstration videos and written materials. The progressive exercise intervention has a wider range of exercise options, and greater flexibility for tailoring, progression, supervised practice and feedback. Conclusion: GRASP has recruited 708 participants and will provide high quality evidence to inform management of people with shoulder pain due to a rotator cuff disorder. Results are anticipated in 2020. Trial registration number: ISRCTN16539266; EudraCT number:2016-002991-28.

Original languageEnglish
Pages (from-to)252-266
Number of pages15
JournalPhysiotherapy (United Kingdom)
Volume107
Early online date9 Jul 2019
DOIs
Publication statusPublished - Jun 2020

Keywords

  • Clinical Trial
  • Exercise
  • Shoulder Pain

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