{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:56:54Z","timestamp":1790639814027,"version":"4.1.0"},"reference-count":47,"publisher":"Georg Thieme Verlag KG","funder":[{"name":"Ilustre Colegio de Fisioterapeutas de Castilla y Le\u00f3n","award":["Beca de investigaci\u00f3n Miguel \u00c1ngel Gal\u00e1n"],"award-info":[{"award-number":["Beca de investigaci\u00f3n Miguel \u00c1ngel Gal\u00e1n"]}]},{"name":"C\u00e1tedra de Conocimiento e Innovaci\u00f3n de la Caja Rural de Soria","award":["Beca para Investigaci\u00f3n"],"award-info":[{"award-number":["Beca para Investigaci\u00f3n"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rehabilitation (Stuttg)"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To compare a specific and graded exercise program (shoulder school) to the\n                        standard care protocol provided in the physiotherapy units of Spanish\n                        primary care centres to patients with rotator cuff-related shoulder pain\n                        (RCRSP).<\/jats:p>\n                  <jats:p>A cluster randomised controlled trial was designed. Seven primary care\n                        centres participated in the study and were randomised into the shoulder\n                        school group (SSG) or the standard care group (SCG). Eighty-seven\n                        participants with RCRSP were included (SSG: n=47; SCG: n=40). Both groups\n                        underwent 16 sessions over eight weeks. The primary outcome was shoulder\n                        pain assessed using a 0-10 VAS over the last three days and during arm\n                        elevation. Secondary outcomes were disability (SPADI and DASH), active range\n                        of motion, isometric strength, quality of life (WORC), and patient\n                        satisfaction (GROC). Outcomes were measured by blinded examiners at baseline\n                        (T0), post-intervention (T1), and after 3 months (T2).<\/jats:p>\n                  <jats:p>Significant differences between-groups were found favouring the SSG for the\n                        primary outcome of pain intensity over the last three days at T1 (Mean\n                        difference [MD]=-2.44, 95% CI -3.18 to -1.69) and T2 (MD=-4.03, 95% CI -4.89\n                        to -3.17), and during arm elevation at T1 (MD=-2.80, 95% CI -3.87 to -1.72)\n                        and T2 (MD=-4.03, 95% CI -5.20 to -2.85), as well as for the secondary\n                        outcomes of disability, range of motion, isometric strength, quality of life\n                        and patients\u2019 satisfaction (T1: p&lt;0.01; T2: p&lt;0.01). Changes in pain\n                        intensity, disability, quality of life and patient satisfaction were higher\n                        than the minimal clinically important difference at T1 and T2, favouring the\n                        SSG.<\/jats:p>\n                  <jats:p>The implementation of shoulder school in primary care physiotherapy units\n                        proved to be statistically and clinically more effective than the standard\n                        protocols in the short- and medium-term, in patients with RCRSP.<\/jats:p>","DOI":"10.1055\/a-2916-5440","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:02:00Z","timestamp":1790636520000},"source":"Crossref","is-referenced-by-count":0,"title":["Implementation of a shoulder school for rotator cuff-related shoulder pain in primary care centres in Spain: A cluster randomised controlled trial"],"prefix":"10.1055","author":[{"given":"Luis","family":"Ceballos Laita","sequence":"additional","affiliation":[{"name":"Valladolid University Hospital, Spain","place":["Soria"],"department":["Physiotherapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rom\u00e1n","family":"Robles-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Valladolid University Hospital, Spain","place":["Soria"],"department":["Physiotherapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Jim\u00e9nez del Barrio","sequence":"additional","affiliation":[{"name":"Valladolid University Hospital, Spain","place":["Soria"],"department":["Physiotherapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noem\u00ed","family":"Arnaiz-Delgado","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Burgos"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Asenjo Altelarrea","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Burgos"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Carretero P\u00e9rez","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Burgos"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Cruces-Saiz","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Burgos"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Mambrillas Varela","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Burgos"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Santos Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Burgos"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Pilar","family":"Aldea Ar\u00e9valo","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Soria"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva Maria","family":"Asensio Asensio","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Soria"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"P\u00e9rez-Vidal","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Soria"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asunci\u00f3n","family":"Cacho del Amo","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Soria"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Casas-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Soria"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00e9s","family":"de Pedro de Miguel","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Soria"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Mart\u00ednez-Montejo","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Soria"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisol","family":"Rup\u00e9rez Serrano","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Soria"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9ctor","family":"Hern\u00e1ndez-L\u00e1zaro","sequence":"additional","affiliation":[{"name":"SACYL, Spain","place":["Soria"],"department":["Physiotherapy primary care"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/J.FT.2012.05.001","article-title":"Trastornos m\u00fasculo-esquel\u00e9ticos del hombro en atenci\u00f3n primaria. 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A cross-sectional international survey of\n                    physiotherapists","volume":"21","author":"J K Powell","year":"2023","journal-title":"Musculoskeletal Care"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.math.2004.07.002","article-title":"Shoulder impingement: The effect of sitting posture on shoulder pain and range\n                    of motion","volume":"10","author":"M P Bullock","year":"2005","journal-title":"Man Ther"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/J.JELEKIN.2015.08.001","article-title":"Fatigue-induced glenohumeral and scapulothoracic kinematic variability:\n                    Implications for subacromial space reduction","volume":"29","author":"J N Chopp-Hurley","year":"2016","journal-title":"Journal of Electromyography and Kinesiology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e0151077","DOI":"10.1371\/JOURNAL.PONE.0151077","article-title":"The Use of Physiotherapy among Patients with Subacromial\n                    Impingement Syndrome: Impact of Sex, Socio-Demographic and Clinical\n                    Factors","volume":"11","author":"D H Christiansen","year":"2016","journal-title":"PLoS One"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1002\/AJIM.10019","article-title":"Risk of shoulder tendinitis in relation to shoulder loads in monotonous\n                    repetitive work","volume":"41","author":"P Frost","year":"2002","journal-title":"Am J Ind Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1093\/PTJ\/PZZ182","article-title":"Relationship Between Shoulder Impingement Syndrome and Thoracic Posture","volume":"100","author":"D J Hunter","year":"2020","journal-title":"Phys Ther"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.jse.2004.08.007","article-title":"Subacromial impingement syndrome: The role of posture and muscle imbalance","volume":"14","author":"J S Lewis","year":"2005","journal-title":"J Shoulder Elbow Surg"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1093\/ptj\/80.3.276","article-title":"Alterations in shoulder kinematics and associated muscle activity in people with\n                    symptoms of shoulder impingement","volume":"80","author":"P M Ludewig","year":"2000","journal-title":"Phys Ther"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"90","DOI":"10.2519\/JOSPT.2009.2808","article-title":"The Association of Scapular Kinematics and Glenohumeral Joint Pathologies","volume":"39","author":"P M Ludewig","year":"2009","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1177\/03635465000280050801","article-title":"Quantification of posterior capsule tightness and motion loss in patients with\n                    shoulder impingement","volume":"28","author":"T F Tyler","year":"2000","journal-title":"Am J Sports Med"},{"key":"ref15","first-page":"99","article-title":"The influence of scapular retraction and protraction on the width of the\n                    subacromial space","author":"E Solem-Bertoft","year":"1993","journal-title":"An MRI study. Clin Orthop Relat Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e300","DOI":"10.1016\/j.jse.2014.04.010","article-title":"Association between kyphosis and subacromial impingement syndrome: LOHAS\n                    study","volume":"23","author":"K Otoshi","year":"2014","journal-title":"J Shoulder Elbow Surg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"574","DOI":"10.2519\/jospt.1999.29.10.574","article-title":"Comparison of 3-dimensional scapular position and orientation between subjects\n                    with and without shoulder impingement","volume":"29","author":"A C Lukasiewicz","year":"1999","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"235","DOI":"10.2519\/JOSPT.2025.13182","article-title":"Rotator Cuff Tendinopathy Diagnosis, Nonsurgical Medical Care, and\n                    Rehabilitation: A Clinical Practice Guideline","volume":"55","author":"F Desmeules","year":"2025","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1016\/j.apmr.2019.12.017","article-title":"Shoulder Rotator Cuff Disorders: A Systematic Review of Clinical Practice\n                    Guidelines and Semantic Analyses of Recommendations","volume":"101","author":"P Doiron-Cadrin","year":"2020","journal-title":"Arch Phys Med Rehabil"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"131","DOI":"10.2519\/JOSPT.2020.8498","article-title":"An Update of Systematic Reviews Examining the Effectiveness of Conservative\n                    Physical Therapy Interventions for Subacromial Shoulder Pain","volume":"50","author":"L Pieters","year":"2020","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"499","DOI":"10.2519\/JOSPT.2024.12453","article-title":"The Efficacy of Exercise Therapy for Rotator Cuff\u2013Related Shoulder Pain\n                    According to the FITT Principle: A Systematic Review With Meta-analyses","volume":"54","author":"S Lafrance","year":"2024","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1136\/BMJ.L294","article-title":"Subacromial decompression surgery for adults with shoulder pain: a clinical\n                    practice guideline","volume":"364","author":"P O Vandvik","year":"2019","journal-title":"BMJ"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1136\/BMJSEM-2023-001646","article-title":"Specific versus general exercise programme in adults with subacromial\n                    impingement syndrome: a randomised controlled trial","volume":"9","author":"H Guti\u00e9rrez Espinoza","year":"2023","journal-title":"BMJ Open Sport Exerc Med"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5661","article-title":"Consort 2010 statement: Extension to cluster randomised trials","volume":"345","author":"M K Campbell","year":"2012","journal-title":"BMJ"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"v","DOI":"10.1016\/J.MATH.2016.05.002","article-title":"The TIDieR (Template for Intervention, descriptor and replication) checklist\n                    will benefit the physiotherapy profession","volume":"24","author":"T Yamato","year":"2016","journal-title":"Man Ther"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2025.103372","article-title":"Reliability, construct validity, responsiveness and minimum clinically important\n                    difference of the numeric pain rating scale and shoulder pain and disability\n                    index in patients with subacromial pain syndrome","volume":"79","author":"I Young","year":"2025","journal-title":"Musculoskelet Sci Pract"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1186\/S12955-015-0397-Z","article-title":"Shoulder pain and disability index: cross cultural validation and evaluation of\n                    psychometric properties of the Spanish version","volume":"13","author":"M D Membrilla-Mesa","year":"2015","journal-title":"Health Qual Life Outcomes"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1157\/13093053","volume-title":"Versi\u00f3n Espa\u00f1ola del cuestionario DASH. Adaptaci\u00f3n transcultural, fiabilidad,\n                    validez y sensibilidad a los cambios","author":"M T Herv\u00e1s","year":"2006"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.math.2012.02.010","article-title":"Within-day reliability of shoulder range of motion measurement with a\n                    smartphone","volume":"17","author":"S H Shin","year":"2012","journal-title":"Man Ther"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.11144\/JAVERIANA.UMED59-3.WORC","article-title":"Reliability and Internal Consistency of the Spanish Version for Colombia of the\n                    Western Ontario Rotator Cuff Index (WORC)","volume":"59","author":"JP M Cano","year":"2018","journal-title":"Universitas Medica"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1097\/MAO.0000000000000421","article-title":"Responsiveness of self-report measures in individuals with vertigo, dizziness,\n          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Musculoskeletal\n                    Practice","volume":"48","author":"G J Lehman","year":"2018","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"984","DOI":"10.2519\/JOSPT.2015.5939","article-title":"Effects of Stretching and Strengthening Exercises, With and Without Manual\n                    Therapy, on Scapular Kinematics, Function, and Pain in Individuals With Shoulder\n                    Impingement: A Randomized Controlled Trial","volume":"45","author":"P R Camargo","year":"2015","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/S41598-020-76704-Z;SUBJMETA","article-title":"No relationship between the acromiohumeral distance and pain in adults with\n                    subacromial pain syndrome: a systematic review and meta-analysis","volume":"10","author":"S W Park","year":"2020","journal-title":"Sci Rep"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"156","DOI":"10.2519\/JOSPT.2021.10199","article-title":"Rotator Cuff\u2013Related Shoulder Pain: Is It Time to Reframe the Advice","volume":"51","author":"K Powell Jared","year":"2021","journal-title":"\u201cYou Need to Strengthen Your Shoulder\u201d?"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/S13102-022-00397-2\/FIGURES\/2","article-title":"The effect of exercise on cytokines: implications for musculoskeletal health: a\n                    narrative review","volume":"14","author":"S Docherty","year":"2022","journal-title":"BMC Sports Sci Med Rehabil"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories,\n                    1990\u20132019: a systematic analysis for the Global Burden of Disease Study\n                    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Rehabilitation"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2916-5440.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:02:01Z","timestamp":1790636521000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2916-5440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":47,"URL":"https:\/\/doi.org\/10.1055\/a-2916-5440","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0034-3536","1439-1309"],"issn-type":[{"value":"0034-3536","type":"print"},{"value":"1439-1309","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]}}}