Gert J.D. Bergman, MSc; Jan C. Winters, PhD, MD; Klaas H. Groenier, MSc; Jan J.M. Pool; Betty Meyboom-de Jong, PhD, MD; Klaas Postema, PhD, MD; Geert J.M.G. van der Heijden, PhD
Note: This trial is being registered in the International Standard Randomised Controlled Trial Number (ISRCTN) Register. The ISRCTN was not available before publication of this article.
Acknowledgments: The authors thank Jettie Nomden and Anton Slagers for assistance with data collection and Juliet Foster for editing the manuscript. They also thank the participating manual therapists, general practitioners, and patients.
Grant Support: By Netherlands Organization for Scientific Research (904-65-901) and Foundation De Drie Lichten.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Gert J.D. Bergman, MSc, Department of General Practice, University of Groningen, PO Box 196, 9700 AD Groningen, the Netherlands; e-mail, email@example.com.
Current Author Addresses: Mr. Bergman, Mr. Groenier, and Dr. Meyboom-de Jong: Department of General Practice, University of Groningen, PO Box 196, 9700 AD Groningen, the Netherlands.
Dr. Winters: Nieuwe Schoolweg 2a, 9756 BB Glimmen, the Netherlands.
Mr. Pool: Institute for Research in Extramural Medicine, Vrije Universiteit Medical Center Amsterdam, Van der Boechorststraat 5, 1081 BT Amsterdam, the Netherlands.
Dr. Postema: Center for Rehabilitation, University Hospital of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands.
Dr. van der Heijden: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (Str. 6.131), PO Box 85500, 3508 GA Utrecht, the Netherlands.
Author Contributions: Conception and design: G.J.D. Bergman, J.C. Winters, B. Meyboom-de Jong, K. Postema, G.J.M.G. van der Heijden.
Analysis and interpretation of the data: G.J.D. Bergman, G.J.M.G. van der Heijden.
Drafting of the article: G.J.D. Bergman.
Critical revision of the article for important intellectual content: J.C. Winters, K.H. Groenier, J.J.M. Pool, B. Meyboom-de Jong, K. Postema, G.J.M.G. van der Heijden.
Final approval of the article: J.J.M. Pool, B. Meyboom-de Jong, K. Postema, G.J.M.G. van der Heijden.
Provision of study materials or patients: J.C. Winters.
Statistical expertise: K.H. Groenier, G.J.M.G. van der Heijden.
Obtaining of funding: J.C. Winters, G.J.M.G. van der Heijden.
Collection and assembly of data: G.J.D. Bergman.
Bergman GJ, Winters JC, Groenier KH, Pool JJ, Jong BM, Postema K, et al. Manipulative Therapy in Addition to Usual Medical Care for Patients with Shoulder Dysfunction and Pain: A Randomized, Controlled Trial. Ann Intern Med. 2004;141:432-439. doi: 10.7326/0003-4819-141-6-200409210-00008
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Published: Ann Intern Med. 2004;141(6):432-439.
Shoulder pain in the absence of trauma, fracture, rupture, or dislocation can lead to substantial functional limitations and can be a difficult condition to treat.
In this randomized, controlled trial, patients with shoulder pain and shoulder girdle dysfunction assigned to receive manipulative therapy in addition to usual general practitioner care had more rapid improvement in symptoms and fewer shoulder symptoms at 12 weeks than patients assigned to usual care alone.
Manipulative therapy appears to be an effective treatment option for patients with shoulder pain and shoulder girdle dysfunction that are not due to trauma, fracture, rupture, or dislocation.
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