Table 3

Description of standardised rehabilitation intervention, as per the template for intervention description and replication guide

Item numberItemDescription
Standardised rehabilitation
2. WHY Describe any rationale, theory or goal of the elements essential to the intervention.The standardised rehabilitation intervention will focus on strengthening of scapular and shoulder muscles. Strengthening exercise were shown to improve pain and disability in participants with subacromial shoulder pain.
Materials: Describe any physical or informational materials used in the intervention, including those provided to participants or used in intervention delivery or in training of intervention providers. Provide information on where the materials can be accessed (eg, online appendix, URL).
The standardised rehabilitation group will receive strengthening exercises. These exercises might be performed with the use of elastic bands or dumbbells. Stretching exercise for the thoracic spine will be done using a foam roller. Two home-based exercises (resisted internal and external rotation of the humerus) will be performed using an elastic band. Detailed information is described on online supplementary file 2.
4.Procedures: Describe each of the procedures, activities and/or processes used in the intervention, including any enabling or support activities.Participants will start with 8 ‘core’ strengthening exercises and three stretches. The clinician can replace one core strengthening exercises by another strengthening exercises from a list of “additional” exercises.
For each category of intervention provider (eg, psychologist, nursing assistant), describe their expertise, background and any specific training given.
Experienced clinicians will deliver interventions for the standardised rehabilitation group. Clinicians will have a postgraduate diploma in musculoskeletal rehabilitation (or related field) and a minimum of 5 years of clinical experience. All clinicians will undergo a trial-specific training programme to ensure they understand the protocol and the rationale of the intervention. Clinicians will receive a detailed manual with information regarding the trial intervention.
6. HOW
Describe the modes of delivery (eg, face-to-face or by some other mechanism, such as internet or telephone) of the intervention and whether it was provided individually or in a group.
Participants will receive individual, face-to-face sessions.
Describe the type(s) of location(s) where the intervention occurred, including any necessary infrastructure or relevant features.
Interventions will be delivered in a private clinical practice.
Describe the number of times the intervention was delivered and over what period of time including the number of sessions, their schedule and their duration, intensity or dose.
Participants will receive 16 sessions, each lasting for a maximum of 60 min, twice per week, over an 8-week period.
The standardised rehabilitation will comprise 8 exercises plus three stretching exercise (one for the cervical spine, one for the thoracic spine and one for the shoulder).
Strengthening exercises will be delivered with the following dosage: 2 sets of 10 repetitions. The strengthening exercises will be progressed in three stages. The first will have the following dosage: 3 sets of 10 repetitions. The second stage will have the following dosage: 3 sets of 20 repetitions. For the third stage of progression, clinicians can choose to increase the load to moderate (based on RPE—see below) or replace the exercise by another one from the additional list.
All the exercises should initially be performed in slow and controlled pace.
The load for strengthening exercises will be determined through using the 10-point Rate of Perceived Exertion (RPE) scale, considering the affected side. Low intensity will be defined as 3–4 RPE, moderate intensity as 5–6 RPE and high intensity as 7–8 RPE.
If the intervention was planned to be personalised, titrated or adapted, then describe what, why, when and how.
This intervention is not planned to be tailored.
If the intervention was modified during the course of the study, describe the changes (what, why, when and how).
Not applicable. This is a protocol.
Planned: If intervention adherence or fidelity was assessed, describe how and by whom and if any strategies were used to maintain or improve fidelity, describe them.
Participants’ adherence to protocol will be assessed by quantifying the number of home-based exercises performed. It will be expressed as percentage of the total number of sessions that should be been performed.
Clinician's adherence to protocol will be assessed by quantifying the number of exercises and progressions that were performed according to the protocol. This will be done through audits of clinical notes, and will be expressed as percentage of the total number of exercises and progressions that were performed during the course of treatment.
12.Actual: If intervention adherence or fidelity was assessed, describe the extent to which the intervention was delivered as planned.Not applicable. This is a protocol.