Central Sensitization and Functional Outcomes in Chronic Shoulder Pain
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Physiotherapy Rehabilitation Program.
- Who it may be relevant to
- Registry conditions: Chronic Shoulder Pain. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Turkey (Türkiye)
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
The Effects of Central Sensitization and Psychological Factors on Functional Outcomes Following Rehabilitation in Individuals With Chronic Shoulder Pain
Overview
This prospective observational cohort study aims to investigate whether baseline central sensitization and psychological factors predict functional outcomes following rehabilitation in individuals with chronic shoulder pain. Participants with chronic shoulder pain will receive a standardized 6-week physiotherapy and rehabilitation program routinely applied in the clinic. Assessments will be performed before and after treatment, including pain severity, shoulder function, central sensitization symptoms, and psychological factors such as pain catastrophizing. The findings of this study may contribute to a better understanding of biopsychosocial factors affecting rehabilitation outcomes in chronic shoulder pain and help improve individualized rehabilitation approaches.
Detailed description
Chronic shoulder pain is one of the most common musculoskeletal disorders and is associated with pain, functional limitations, reduced quality of life, and work disability. Although structural abnormalities are often identified in clinical evaluation and imaging findings, the relationship between tissue pathology and symptom severity is not always clear. Therefore, factors beyond peripheral tissue damage may contribute to persistent shoulder pain and rehabilitation outcomes.
In recent years, central sensitization has become an important concept in chronic musculoskeletal pain conditions. Central sensitization refers to increased responsiveness of the central nervous system to sensory input, resulting in pain hypersensitivity and amplification of pain perception. Previous studies have demonstrated that individuals with chronic shoulder pain may present with symptoms related to central sensitization, which can negatively affect pain severity, disability, and treatment response.
Psychological factors such as pain catastrophizing, fear of movement, anxiety, and depression are also known to influence chronic pain experiences and rehabilitation outcomes. Higher levels of maladaptive psychological responses may contribute to increased pain perception, reduced treatment adherence, and poorer functional recovery. However, prospective studies evaluating the combined influence of central sensitization and psychological factors on rehabilitation outcomes in chronic shoulder pain remain limited.
This study is designed as a prospective observational cohort study. Individuals with chronic shoulder pain attending physiotherapy rehabilitation clinics will be recruited. Participants will undergo baseline assessments before treatment and follow-up assessments after a standardized 6-week rehabilitation program routinely applied in clinical practice.
The primary objective is to determine whether baseline central sensitization and psychological factors predict functional improvement following rehabilitation. The findings may contribute to a better understanding of the biopsychosocial mechanisms underlying treatment response and support the development of more individualized rehabilitation strategies for chronic shoulder pain management.
Interventions
- Other Physiotherapy Rehabilitation Program
A standardized 6-week exercise-based physiotherapy and rehabilitation program routinely applied in clinical practice, including patient education, scapular stabilization exercises, strengthening exercises, range of motion exercises, functional training, and home exercise recommendations for individuals with chronic shoulder pain.
Primary outcome measures
- Shoulder Pain and Disability Index (SPADI) [Time frame: Baseline and 6 weeks after rehabilitation]
Secondary outcome measures (5)
- Central Sensitization Inventory (CSI) [Time frame: Baseline and 6 weeks after rehabilitation]
- Pain Catastrophizing Scale (PCS) [Time frame: Baseline and 6 weeks after rehabilitation]
- Pain Intensity (Visual Analog Scale) [Time frame: Baseline and 6 weeks after rehabilitation]
- Shoulder Range of Motion [Time frame: Baseline and 6 weeks after rehabilitation]
- Shoulder Muscle Strength [Time frame: Baseline and 6 weeks after rehabilitation]
Eligibility criteria
Inclusion criteria
- Adults aged 18 years and older
- Presence of chronic shoulder pain lasting at least 3 months
- Clinical findings consistent with shoulder-related pain
- Willingness to participate in a 6-week physiotherapy rehabilitation program
- Ability to complete study assessments and questionnaires
- Provision of written informed consent
Exclusion criteria
- History of shoulder surgery within the previous 6 months
- Major shoulder trauma within the previous 6 months
- Serious pathology affecting the shoulder (e.g., infection, tumor, systemic inflammatory disease)
- Neurological disorders affecting the upper extremity (e.g., cervical radiculopathy, myelopathy, peripheral nerve injury)
- Severe cognitive impairment
- Communication problems preventing participation
- Shoulder injection within the previous 4 weeks
- Pregnancy
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Turkey (Türkiye) · 1 center
- Burdur Mehmet Akif Ersoy Üniversitesi — Burdur
Identifiers
NCT: NCT07654023 · CS-Shoulder-2026