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

Citations

David J Keene, Hessam Soutakbar, Sally Hopewell, Peter Heine, Anju Jaggi, Christopher Littlewood, Zara Hansen, Karen Barker, Willie Hamilton, Andrew J. Carr, Sarah E. Lamb. 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. Physiotherapy Available online 9 July 2019

Sponsorship: Supported by the NIHR

DOI: https://doi.org/10.1016/j.physio.2019.07.002

URI: https://www.oxfordhealth.nhs.uk/orka/title/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/