[Physio Explained] Manual therapy improves outcomes in shoulder pain with Robin Kerr
Oct 23, 2024
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Robin Kerr, an experienced Australian physiotherapist specializing in pelvic floor dysfunction and biomechanics, joins the discussion on enhancing shoulder pain management. They delve into a study showing how adding manual therapy to exercise can significantly improve long-term outcomes for subacromial shoulder pain. Kerr emphasizes the importance of personalized treatment, subgroup analysis, and the therapist-patient relationship. They also tackle the challenges of conflicting research and advocate for tailored approaches that consider individual patient needs.
Combining manual therapy with exercise significantly enhances long-term outcomes for patients with subacromial shoulder pain, contrary to previous research suggesting only short-term benefits.
A patient-centered approach is crucial in treatment selection, emphasizing the need for individualization based on psychological factors and specific patient characteristics.
Deep dives
Effectiveness of Manual Therapy with Exercise
Adding manual therapy to an exercise program significantly improves long-term patient outcomes for those suffering from subacromial shoulder pain. A randomized control trial showed that patients who received both manual therapy and exercise reported greater reductions in pain and disability at six and twelve months compared to those who only received exercise. The consistent and standardized application of both interventions helped to limit variability, making the results more reliable. This challenges previous research that suggested manual therapy only provided short-term benefits and highlights the need for further exploration into its long-term effects.
Understanding Conflicting Research
The podcast addresses the confusion among physiotherapists due to conflicting research findings regarding the benefits of manual therapy. Many studies published in recent years have suggested that the addition of manual therapy offers little to no advantage over exercise alone, leading to uncertainty within the profession. However, the latest findings indicate a significant long-term benefit when combining the two approaches, raising questions about the quality and methodology of earlier research. This highlights the importance of considering the therapeutic alliance as a potential factor influencing patient outcomes.
Patient-Centered Care and Subgrouping
Focusing on patient-centered care is essential in determining the appropriate treatment approach for individuals with shoulder pain. Tailoring interventions based on specific patient characteristics, such as psychological factors like fear avoidance, can enhance treatment effectiveness. The discussion emphasizes the necessity for subgrouping patients to identify who might benefit more from manual therapy versus exercise alone. Recognizing the contextual and psychosocial elements in treatment can help clinicians develop more effective and individualized care strategies.
In this episode with Robin Kerr, we explore a recent paper looking at the addition of manual therapy to an exercise program for subacromial shoulder pain. We discuss:
Discrepancies in current shoulder research
Importance of individual patient treatment selection
Exercises used within this paper for shoulder rehabilitation
Reference to paper - Michener L, McClure P, Tate A, Bailey L, Seitz A, Straub R, Thigpen C (2023) Adding Manual Therapy to an Exercise Program Improves Long-term Patient Outcomes Over Exercise Alone in Patients with Subacromial Shoulder Pain: A Randomized Clinical Trial. JOSPT, Published Online, 0,1-31
Robin Kerr is an Australian trained physiotherapist with over three decades of clinical experience. Her special interests lay in helping patients with pelvic floor and lumbo-pelvic dysfunction. She is heavily trained in biomechanics and gait lab running analysis and continues to assist elite athletes with injuries.
If you like the podcast, it would mean the world if you're happy to leave us a rating or a review. It really helps!
Our host is @sarah.yule from Physio Network
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