Experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST): a nested qualitative study

Objectives To explore the experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST), a multicentre randomised controlled trial that compared manipulation under anaesthesia (MUA), arthroscopic capsular release (ACR) with a 12-week early...

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Main Authors: Amar Rangan, Sarah Lamb, Matthew Northgraves, Stephen Brealey, Francine Toye, Cynthia Srikesavan, Lorna Goodchild, Charalambos P Charalambous
Format: Article
Language:English
Published: BMJ Publishing Group 2021-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/6/e040829.full
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author Amar Rangan
Sarah Lamb
Matthew Northgraves
Stephen Brealey
Francine Toye
Cynthia Srikesavan
Lorna Goodchild
Charalambos P Charalambous
author_facet Amar Rangan
Sarah Lamb
Matthew Northgraves
Stephen Brealey
Francine Toye
Cynthia Srikesavan
Lorna Goodchild
Charalambos P Charalambous
author_sort Amar Rangan
collection DOAJ
description Objectives To explore the experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST), a multicentre randomised controlled trial that compared manipulation under anaesthesia (MUA), arthroscopic capsular release (ACR) with a 12-week early structured physiotherapy programme (ESP) in people with unilateral frozen shoulder referred to secondary care.Design Nested qualitative study with semistructured interviews. We used constant comparison method to develop our themes.Setting This qualitative study was nested within the UK FROST.Participants 44 trial participants (ESP: 14; MUA: 15; ACR: 15), and 8 surgeons and 8 physiotherapists who delivered the treatments in the trial.Results Trial participants found UK FROST treatments acceptable and satisfactory in terms of content, delivery and treatment benefits. Participants in all arms experienced improvements in pain, shoulder movements, and function. Participants said they would choose the same treatment that they received in the trial.Surgeons and physiotherapists felt that the content and delivery of UK FROST treatments was not significantly different to their routine practice except for the additional number of physiotherapy sessions offered in the trial. They had mixed feelings about the effectiveness of UK FROST treatments. Both stressed the value of including hydrodilatation as a comparator of other treatment options. Physiotherapists raised concerns about the capacity to deliver the number of UK FROST physiotherapy sessions in routine clinical settings.Shared perceptions of trial participants, surgeons and physiotherapists were: (1) Pain relief and return of shoulder movements and function are important outcomes and (2) Adherence to exercises leads to better outcomes.Conclusion In general, our findings indicated that trial participants, and surgeons and physiotherapists who delivered the treatments had positive experiences and perceptions in the UK FROST. Early qualitative investigations to explore the feasibility of delivering treatments in real-world settings are suggested in future trials in the frozen shoulder.Trial registration number International Standard Randomised Controlled Trial Register, ID: ISRCTN48804508. Registered on 25 July 2014; Results
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spelling doaj-art-e6fd64b0bd724ca4a2dbc8aba5f008df2024-11-19T19:05:08ZengBMJ Publishing GroupBMJ Open2044-60552021-06-0111610.1136/bmjopen-2020-040829Experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST): a nested qualitative studyAmar Rangan0Sarah Lamb1Matthew Northgraves2Stephen Brealey3Francine Toye4Cynthia Srikesavan5Lorna Goodchild6Charalambos P Charalambous76 Trauma and Orthopaedics, James Cook University Hospital, Middlesbrough, UKCollege of Medicine and Health, University of Exeter, Exeter, UK1University of Hull, UKYork Trials Unit, ARRC Building, Department of Health Sciences, University of York, York, UKNuffield Orthopaedic Centre Physiotherapy Research Unit, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK2 Centre for Rehabilitation Research in Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UKThe James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UKBlackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UKObjectives To explore the experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST), a multicentre randomised controlled trial that compared manipulation under anaesthesia (MUA), arthroscopic capsular release (ACR) with a 12-week early structured physiotherapy programme (ESP) in people with unilateral frozen shoulder referred to secondary care.Design Nested qualitative study with semistructured interviews. We used constant comparison method to develop our themes.Setting This qualitative study was nested within the UK FROST.Participants 44 trial participants (ESP: 14; MUA: 15; ACR: 15), and 8 surgeons and 8 physiotherapists who delivered the treatments in the trial.Results Trial participants found UK FROST treatments acceptable and satisfactory in terms of content, delivery and treatment benefits. Participants in all arms experienced improvements in pain, shoulder movements, and function. Participants said they would choose the same treatment that they received in the trial.Surgeons and physiotherapists felt that the content and delivery of UK FROST treatments was not significantly different to their routine practice except for the additional number of physiotherapy sessions offered in the trial. They had mixed feelings about the effectiveness of UK FROST treatments. Both stressed the value of including hydrodilatation as a comparator of other treatment options. Physiotherapists raised concerns about the capacity to deliver the number of UK FROST physiotherapy sessions in routine clinical settings.Shared perceptions of trial participants, surgeons and physiotherapists were: (1) Pain relief and return of shoulder movements and function are important outcomes and (2) Adherence to exercises leads to better outcomes.Conclusion In general, our findings indicated that trial participants, and surgeons and physiotherapists who delivered the treatments had positive experiences and perceptions in the UK FROST. Early qualitative investigations to explore the feasibility of delivering treatments in real-world settings are suggested in future trials in the frozen shoulder.Trial registration number International Standard Randomised Controlled Trial Register, ID: ISRCTN48804508. Registered on 25 July 2014; Resultshttps://bmjopen.bmj.com/content/11/6/e040829.full
spellingShingle Amar Rangan
Sarah Lamb
Matthew Northgraves
Stephen Brealey
Francine Toye
Cynthia Srikesavan
Lorna Goodchild
Charalambos P Charalambous
Experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST): a nested qualitative study
BMJ Open
title Experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST): a nested qualitative study
title_full Experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST): a nested qualitative study
title_fullStr Experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST): a nested qualitative study
title_full_unstemmed Experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST): a nested qualitative study
title_short Experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST): a nested qualitative study
title_sort experiences and perceptions of trial participants and healthcare professionals in the uk frozen shoulder trial uk frost a nested qualitative study
url https://bmjopen.bmj.com/content/11/6/e040829.full
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