ClinicalTrials.gg
CompletedNCT06886932PNE-RCSUpdated Sep 30, 2026

Pain Education After Rotator Cuff Surgery

An observational study in Rotator Cuff Tears, Postoperative Pain Management and Shoulder Dysfunction, sponsored by Elif Dilara Durmaz. Completed at 1 site in Turkey (Türkiye). Open to participants aged 40 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-30.

Sponsored by Elif Dilara Durmaz · Observational

Updated Sep 30, 2026Now CompletedPrimary completion moved+2 moreGo to Updates ↓
Study type
Observational
Model
Other
Time perspective
Prospective
Enrollment
52
Ages
40 Years to 75 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 85 studies in Rotator Cuff Injuries with a site in Turkey — 19 open to participants now, 23 under way, none of them phase 3. Rotator Cuff Injuries · Turkey.

Enrollment
10th of 22
52 · median 50
Started
2025
with 11 others
Observational
22 of 85
8 open now
Registered
60th of 85
by date
Lead sponsor
2 of 85
Elif Dilara Durmaz

Among the 85 studies in Rotator Cuff Injuries with a site in Turkey, this one is the 10th largest by enrollment of the 22 observational ones, is one of 12 that started in 2025, is one of 22 observational ones, and was the 60th registered.

By phase

85 studies; the count open now beside each. This study's row is marked.

No phase63 · 11 open
Observationalthis study22 · 8 open

By the year they started

First in 2016; this study’s year is marked. 12 started in 2025.

Size and results

Median enrollment 44 across the 63 interventional studies, 50 across the 22 observational. Of the 57 that completed or were terminated, 1 (2%) have results posted.

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02

Study summary

Study Title: The Effect of Pain Neuroscience Education Combined with Conventional Rehabilitation on Pain Management and Functional Outcomes in Patients Undergoing Mini-Open Rotator Cuff Repair

Purpose: This study aims to investigate whether adding Pain Neuroscience Education (PNE) to a conventional rehabilitation program improves pain management, physical function, and psychosocial outcomes in patients who have undergone mini-open surgery for rotator cuff tears (RCT). The study will also compare the effects of PNE when delivered before versus after surgery.

Who Can Participate: Adults aged 40-75 who have been diagnosed with a medium-sized rotator cuff tear and are scheduled for mini-open surgical repair. Participants must meet specific health criteria and be willing to participate in the rehabilitation program.

Study Details:

Participants will be randomly assigned to one of three groups:

Group 1: Conventional rehabilitation only. Group 2: Conventional rehabilitation + PNE before surgery. Group 3: Conventional rehabilitation + PNE after surgery. PNE involves educational sessions that explain the biology of pain, how the nervous system processes pain, and strategies to reduce fear and catastrophizing related to pain.

The study will last approximately 12 weeks, with regular assessments of pain levels, physical function, and psychosocial factors (e.g., fear of movement, depression, sleep quality).

Potential Benefits:

Participants may experience reduced pain, improved shoulder function, and better overall recovery.

The study may provide valuable insights into how PNE can enhance rehabilitation outcomes for patients with rotator cuff tears.

Potential Risks:

Some participants may find the educational sessions time-consuming or mentally challenging.

There is a small risk of discomfort during physical assessments or rehabilitation exercises.

Why is this study important?:

Rotator cuff tears are a common cause of shoulder pain and disability, especially in older adults. Post-surgical pain and fear of movement can slow recovery and reduce quality of life. This study will help determine whether PNE, when combined with conventional rehabilitation, can improve recovery outcomes and provide a better understanding of how timing (before or after surgery) affects its effectiveness.

Read the detailed description

Background and Rationale

Rotator cuff tears (RCT) are a leading cause of shoulder pain and disability, particularly in aging populations. The prevalence of RCT increases with age, affecting approximately 28% of individuals aged 40 and rising to 60-80% in those aged 80. Surgical repair, such as mini-open rotator cuff repair, is often required for medium to large tears or when conservative treatments fail. While surgery aims to reduce pain and restore function, postoperative recovery can be challenging due to severe pain, fear of movement (kinesiophobia), and psychosocial factors like anxiety and depression. These factors can hinder rehabilitation and delay recovery.

Pain Neuroscience Education (PNE) is an evidence-based approach that teaches patients about the biological and psychological mechanisms of pain. By helping patients understand how pain is processed by the nervous system, PNE reduces fear, catastrophizing, and negative beliefs about pain, thereby improving outcomes. While PNE has been shown to be effective in chronic pain conditions, its application in acute postoperative settings, particularly for rotator cuff repair, remains underexplored.

Study Objectives

This study aims to:

Evaluate the effectiveness of combining PNE with conventional rehabilitation in improving pain management, physical function, and psychosocial outcomes in patients undergoing mini-open rotator cuff repair.

Compare the effects of delivering PNE before surgery versus after surgery. Assess the impact of PNE on secondary outcomes, including kinesiophobia, depression, pressure pain threshold, conditioned pain modulation, sleep quality, postural alignment, and functional level.

Study Design

This is a randomized controlled trial with three parallel groups:

Group 1 (Control): Conventional rehabilitation only. Group 2 (Preoperative PNE): Conventional rehabilitation + PNE delivered before surgery.

Group 3 (Postoperative PNE): Conventional rehabilitation + PNE delivered after surgery.

Methodology

Participants: Adults aged 18-65 with a diagnosed medium-sized rotator cuff tear scheduled for mini-open surgical repair.

Intervention:

PNE: A structured educational program consisting of 2-3 sessions (45-60 minutes each) that explain the neurobiology of pain, the role of the central nervous system, and strategies to reduce pain-related fear and catastrophizing.

Conventional Rehabilitation: A standardized postoperative rehabilitation program focusing on pain management, range of motion, strength training, and functional recovery.

Outcome Measures:

Primary Outcomes: Pain intensity (measured by Visual Analog Scale), shoulder function (measured by Constant-Murley Score), and kinesiophobia (measured by Tampa Scale of Kinesiophobia).

Secondary Outcomes: Depression (measured by Beck Depression Inventory), pressure pain threshold, conditioned pain modulation, sleep quality (measured by Pittsburgh Sleep Quality Index), postural alignment, and functional level.

Timeline: Participants will be assessed at baseline (pre-surgery), immediately after PNE (if applicable), and at 6 and 12 weeks post-surgery.

Statistical Analysis

Data will be analyzed using intention-to-treat principles. Repeated-measures ANOVA will be used to compare outcomes across groups and time points. Subgroup analyses will explore the effects of PNE timing (preoperative vs. postoperative).

Significance

This study addresses a critical gap in the management of rotator cuff tears by investigating the role of PNE in enhancing postoperative recovery. If effective, PNE could be integrated into standard rehabilitation protocols to improve pain management, reduce fear of movement, and accelerate functional recovery. The study also aims to determine the optimal timing for PNE delivery, providing valuable insights for clinical practice.

03

Conditions studied

  • Rotator Cuff Tears
  • Postoperative Pain Management
  • Shoulder Dysfunction
  • Kinesiophobia (Fear of Movement)
  • Postoperative Rehabilitation

Keywords

  • Pain Neuroscience Education
  • Postoperative Rehabilitation
  • Rotator Cuff Tear
  • Kinesiophobia
  • Shoulder Surgery Outcomes
  • Postoperative Pain Management
04

Who can participate

Ages eligible
40 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

The study population consists of adult patients aged 40-75 years who have been diagnosed with a medium-sized rotator cuff tear (1-3 cm) confirmed by Magnetic Resonance Imaging (MRI) and are scheduled for surgical repair using the mini-open surgical technique.

Participants must meet the following inclusion criteria:

Ability to understand and complete the informed consent form and related assessment scales in Turkish.

A score of 24 or higher on the Mini-Mental State Examination (MMSE) to ensure adequate cognitive function for participation.

Patients will be excluded if they have:

Received a corticosteroid injection within the last 6 weeks. Evidence of adhesive capsulitis (loss of passive external rotation greater than 50% or 30°).

A history of prior cervical, thoracic, or shoulder surgery. Cervical radiculopathy, acromioclavicular pathology, shoulder instability, or a full-thickness rotator cuff tear.

Calcific tendinitis, systemic diseases (e.g., inflammatory arthritis, malignancy), o

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Eligibility Criteria

Inclusion criteria

Inclusion Criteria:

Diagnosis of a medium-sized rotator cuff tear (1-3 cm) confirmed by Magnetic Resonance Imaging (MRI) and scheduled for surgical repair Age between 40 and 75 years Sufficient Turkish language proficiency to understand and complete the form and assessment scales (MMSE) score ≥ 24, indicating adequate cognitive function for study participation

Exclusion criteria

Exclusion Criteria:

injection received within the last 6 weeks Adhesive capsulitis, defined as loss of passive external rotation greater than 50% or 30° History of previous cervical, thoracic, or shoulder surgery Presence of cervical radiculopathy, characterized by pain and tingling radiating to the arm due to nerve root involvement Acromioclavicular joint pathology or shoulder instability causing shoulder pain Full-thickness rotator cuff tear Calcific tendinitis Systemic diseases (e.g., inflammatory arthritis, ) or neurological disorders (e.g., fibromyalgia, other neurological deficits) Fracture, labral lesion, or biceps tendon injury in the affected shoulder Prior participation in a chronic pain psychological management program or presence of generalized body pain

Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Observational model
Other
Time perspective
Prospective
Enrollment
52 participants (actual)
Patient registry
No

Groups and cohorts

  • ANE + Rehabilitation (Preoperative)

    Patients in this group will receive Pain Neuroscience Education (ANE) before surgery, combined with a conventional rehabilitation program. The ANE will include education on pain mechanisms, neurophysiology, and the role of the central nervous system in pain perception. The conventional rehabilitation program will consist of exercises, manual therapy, and functional training tailored to rotator cuff repair recovery.

  • ANE + Conventional Rehabilitation (Postoperative)

    Patients in this group will receive Pain Neuroscience Education (ANBE) after surgery, combined with a conventional rehabilitation program. The ANBE will focus on reducing pain catastrophizing, anxiety, and kinesiophobia, while the rehabilitation program will include postoperative exercises, mobility training, and strength-building activities.

  • Conventional Rehabilitation Only (Control Group)

    Patients in this group will receive only the conventional rehabilitation program without any additional Pain Neuroscience Education. The rehabilitation program will include standard postoperative exercises, mobility training, and strength-building activities, as per the clinical guidelines for rotator cuff repair recovery

06

What researchers measure

Primary outcomes

  1. Pain Intensity

    Description: Pain intensity will be measured using the Numeric Analog Scale (NAS). Patients will rate their pain on a scale from 0 (no pain) to 10 (worst pain imaginable). Pain intensity will be measured using the Numeric Rating Scale (NRS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable. Higher scores represent worse outcomes.

    Time frame: Time Frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

  2. Pressure Pain Threshold (PPT)

    PPT will be measured using a digital algometer to assess changes in pain sensitivity at the shoulder region. This measures the minimum pressure required to elicit pain.

    Time frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

  3. Conditioned Pain Modulation (CPM)

    CPM will be evaluated to assess the efficiency of the endogenous pain modulation system. This measures the body's ability to modulate pain through conditioned stimuli.

    Time frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

Secondary outcomes

  1. Kinesiophobia (Fear of Movement)

    Kinesiophobia will be measured using the Tampa Scale of Kinesiophobia (TSK), which assesses fear of movement and reinjury.

    Time frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

  2. Sleep Quality

    Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI), which evaluates sleep duration, disturbances, and overall sleep quality.Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI). The PSQI total score ranges from 0 to 21, with higher scores indicating poorer sleep quality (i.e., a worse outcome).

    Time frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

  3. Depression and Anxiety

    Depression and anxiety levels will be assessed using the Depression Anxiety Stress Scale-21 (DASS-21), which consists of 21 items with three subscales: depression, anxiety, and stress. Each item is scored on a scale from 0 (did not apply to me at all) to 3 (applied to me very much or most of the time). Higher scores indicate greater levels of psychological distress (i.e., a worse outcome).

    Time frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

  4. Shoulder Functionality

    Shoulder functionality will be assessed using the Shoulder Pain and Disability Index (SPADI), which evaluates pain and disability during daily activities. The total score ranges from 0 to 130, with higher scores indicating greater shoulder disability and pain (i.e., a worse outcome).

    Time frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

  5. Modified Constant-Murley Shoulder Score (MCOS)

    Shoulder Function (Modified Constant-Murley Shoulder Score) Description: Shoulder function will be evaluated using the Modified Constant-Murley Shoulder Score (MCOS), which assesses pain, activities of daily living, range of motion, and strength. The total score ranges from 0 to 100, with lower scores indicating reduced shoulder function (i.e., a worse outcome).

    Time frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

  6. Functional Impairment Test-Hand, Neck, and Shoulder (FIT-HaNSA)

    Functional impairment in the hand, neck, and shoulder regions will be assessed using the Functional Impairment Test-Hand, Neck, and Shoulder (FIT-HaNSA). The test consists of three subtasks, each performed for a maximum of 5 minutes, with specific stopping rules applied based on fatigue or inability to continue the task. Longer task durations indicate better functional capacity (i.e., a better outcome)..

    Time frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

Other outcomes

  1. Postural Alignment

    Postural alignment will be assessed using FizyoPrint Mobile Application, which evaluates posture and body composition. Participants will be photographed from the front, back, and side while standing in a relaxed position. The application will generate a detailed report of postural variables.

    Time frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

  2. Muscle Elastography

    Muscle stiffness and integrity will be evaluated using Shear Wave Elastography (SWE). SWE measures the mechanical properties of the supraspinatus tendon and muscle, with higher stiffness values indicating better tissue integrity.

    Time frame: 2 weeks before surgery (preoperative) and 8 weeks after surgery (postoperative).

07

Study locations

1 site
  • Karaman Training and Research Hospital
    Karaman, Turkey (Türkiye)
08

References and documents

Individual participant data

Plan to share: Yes — We plan to share de-identified individual participant data (IPD) including demographic information, clinical assessments, and key outcome measures. The data will be made available through a secure, publicly accessible data repository after the primary study results have been published. Access to the data will be provided upon request and will require submission of a research proposal for review by an independent data access committee. Data sharing will be conducted in accordance with ethical guidelines to ensure participant confidentiality and privacy.

Supporting information: Clinical study report, Analytic code

Time frame: End Date: The date when access to the data will be closed. Typically, this could be a period after the data has been shared, such as a few years after the study completion.

Access criteria: Access will be provided through a secure, controlled-access platform (e.g., [insert platform name, e.g., ClinicalStudyDataRequest.com]). Researchers will need to submit a formal request and provide a research proposal. Access will be granted after approval by an independent data access committee and once a data use agreement has been signed.

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Apr 2025 to primary completion in Sep 2026, 17 months.

Of 57 non-industry observational studies under Rotator Cuff Injuries, half reached primary completion within 42 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 67. This study's 17 months is below that.

Counting every sponsor, half of 72 studies reached it within 46 months; a quarter within 17 and three quarters within 165.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 14, 2025
First posted
Mar 20, 2025
StartActual
Apr 1, 2025
Primary completionActual
Sep 29, 2026
CompletionActual
Sep 29, 2026
Last update
Sep 30, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Status
Recruiting→Completed
changed Sep 30, 2026
Primary completion
Sep 30, 2026→Sep 29, 2026 (actual)
Sep 30, 2026
Study completion
Sep 30, 2026→Sep 29, 2026 (actual)
Sep 30, 2026
Enrollment
45 (estimated)→52 (actual)
Sep 30, 2026
Show all 1 update
  1. Sep 30, 2026
    Recruiting→Completed
    Primary completion Sep 30, 2026→Sep 29, 2026 (now actual)
    Study completion Sep 30, 2026→Sep 29, 2026 (now actual)
    Enrollment 45 (estimated)→52 (actual)
    + 3 other changes: verification date, contact details and site details

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06886932
Lead sponsor
Elif Dilara Durmaz
Collaborators
Karaman Training and Research Hospital
Responsible party
Elif Dilara Durmaz (invenstigator, Istinye University) — Sponsor-investigator
First posted
Mar 20, 2025
Start date
Apr 1, 2025
Primary completion
Sep 29, 2026
Completion
Sep 29, 2026
Last update
Sep 30, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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