Effect of a Novel Training Program in Patients With Chronic Shoulder Pain Based on Implicit Motor Learning: Pilot and Feasibility Study.

# Background Implicit motor learning has been shown to be effective for learning sports-related motor skills. It facilitates automaticity of movements and thereby improves performance in multitasking and high-pressure environments. Motor learning to develop motor skills and neuroplastic capacities...

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Main Authors: Annelies Maenhout, Wieger Heijenk, Peter Glashouwer, Lore Quatacker, Luna Praet, Dorien Borms
Format: Article
Language:English
Published: North American Sports Medicine Institute 2024-01-01
Series:International Journal of Sports Physical Therapy
Online Access:https://doi.org/10.26603/001c.90284
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author Annelies Maenhout
Wieger Heijenk
Peter Glashouwer
Lore Quatacker
Luna Praet
Dorien Borms
author_facet Annelies Maenhout
Wieger Heijenk
Peter Glashouwer
Lore Quatacker
Luna Praet
Dorien Borms
author_sort Annelies Maenhout
collection DOAJ
description # Background Implicit motor learning has been shown to be effective for learning sports-related motor skills. It facilitates automaticity of movements and thereby improves performance in multitasking and high-pressure environments. Motor learning to develop motor skills and neuroplastic capacities is not sufficiently incorporated in musculoskeletal rehabilitation. Especially in patients with chronic pain conditions like shoulder pain this approach might benefit over traditional exercise programs. # Purpose/hypothesis The aim of this study was to investigate the feasibility and clinical outcome of a new implicit motor learning exercise program in a group of patients with chronic shoulder pain. # Study design Pilot and feasibility cohort study # Methods Twenty-six patients with chronic shoulder pain performed a 6-week home exercise program with weekly remote follow up by a physiotherapist. The program comprised five exercises designed to challenge overall body balance, simultaneously engaging the upper limbs in a range of reaching tasks. The tasks included reaching above the head, at and below waist level, in various directions. No instructions on correct performance were provided to foster external focus. Feasibility was assessed by (1) recruitment rate, (2) follow up rate, (3) subjective experience, (4) self-reported adverse events and (5) self-reported adherence of subjects. Clinical effects of the program were assessed with (1) the Shoulder Pain and Disability Index (SPADI), (2) the Auto-Constant score, (3) the numeric rating scale (NRS) at rest and at night, (4) the patient specific functional scale (PSFS), (5) the avoidance endurance questionnaire (AEQ), (6) patient acceptable symptom state (PASS) and (7) a global rating of change (GROC). # Results The study protocol was feasible in terms of follow up rate (16w for 28 patients), exercise adherence (77.1%± 29.41), and adverse events (no serious, 5 light adverse events). Statistically significant improvements were observed for SPADI (p\<0.001), NRS at rest (p=0.033), at night (p=0.29), PSFS (p\<0.001) and PASS (p\<0.001) after only six weeks training. # Conclusion This study reveals promising results of another way of looking at exercise for patients with chronic shoulder pain. Both feasibility and clinical effects of the program on pain and function was acceptable. Future studies should incorporate a control group, provide longer follow up and include objective measurements. # Level of evidence 2b
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spelling doaj-art-87e970f5d3e14c3586e4c17ee7973d282025-02-11T20:27:51ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962024-01-01191Effect of a Novel Training Program in Patients With Chronic Shoulder Pain Based on Implicit Motor Learning: Pilot and Feasibility Study.Annelies MaenhoutWieger HeijenkPeter GlashouwerLore QuatackerLuna PraetDorien Borms# Background Implicit motor learning has been shown to be effective for learning sports-related motor skills. It facilitates automaticity of movements and thereby improves performance in multitasking and high-pressure environments. Motor learning to develop motor skills and neuroplastic capacities is not sufficiently incorporated in musculoskeletal rehabilitation. Especially in patients with chronic pain conditions like shoulder pain this approach might benefit over traditional exercise programs. # Purpose/hypothesis The aim of this study was to investigate the feasibility and clinical outcome of a new implicit motor learning exercise program in a group of patients with chronic shoulder pain. # Study design Pilot and feasibility cohort study # Methods Twenty-six patients with chronic shoulder pain performed a 6-week home exercise program with weekly remote follow up by a physiotherapist. The program comprised five exercises designed to challenge overall body balance, simultaneously engaging the upper limbs in a range of reaching tasks. The tasks included reaching above the head, at and below waist level, in various directions. No instructions on correct performance were provided to foster external focus. Feasibility was assessed by (1) recruitment rate, (2) follow up rate, (3) subjective experience, (4) self-reported adverse events and (5) self-reported adherence of subjects. Clinical effects of the program were assessed with (1) the Shoulder Pain and Disability Index (SPADI), (2) the Auto-Constant score, (3) the numeric rating scale (NRS) at rest and at night, (4) the patient specific functional scale (PSFS), (5) the avoidance endurance questionnaire (AEQ), (6) patient acceptable symptom state (PASS) and (7) a global rating of change (GROC). # Results The study protocol was feasible in terms of follow up rate (16w for 28 patients), exercise adherence (77.1%± 29.41), and adverse events (no serious, 5 light adverse events). Statistically significant improvements were observed for SPADI (p\<0.001), NRS at rest (p=0.033), at night (p=0.29), PSFS (p\<0.001) and PASS (p\<0.001) after only six weeks training. # Conclusion This study reveals promising results of another way of looking at exercise for patients with chronic shoulder pain. Both feasibility and clinical effects of the program on pain and function was acceptable. Future studies should incorporate a control group, provide longer follow up and include objective measurements. # Level of evidence 2bhttps://doi.org/10.26603/001c.90284
spellingShingle Annelies Maenhout
Wieger Heijenk
Peter Glashouwer
Lore Quatacker
Luna Praet
Dorien Borms
Effect of a Novel Training Program in Patients With Chronic Shoulder Pain Based on Implicit Motor Learning: Pilot and Feasibility Study.
International Journal of Sports Physical Therapy
title Effect of a Novel Training Program in Patients With Chronic Shoulder Pain Based on Implicit Motor Learning: Pilot and Feasibility Study.
title_full Effect of a Novel Training Program in Patients With Chronic Shoulder Pain Based on Implicit Motor Learning: Pilot and Feasibility Study.
title_fullStr Effect of a Novel Training Program in Patients With Chronic Shoulder Pain Based on Implicit Motor Learning: Pilot and Feasibility Study.
title_full_unstemmed Effect of a Novel Training Program in Patients With Chronic Shoulder Pain Based on Implicit Motor Learning: Pilot and Feasibility Study.
title_short Effect of a Novel Training Program in Patients With Chronic Shoulder Pain Based on Implicit Motor Learning: Pilot and Feasibility Study.
title_sort effect of a novel training program in patients with chronic shoulder pain based on implicit motor learning pilot and feasibility study
url https://doi.org/10.26603/001c.90284
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