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Trial registered on ANZCTR
Registration number
ACTRN12615000351516
Ethics application status
Approved
Date submitted
30/03/2015
Date registered
17/04/2015
Date last updated
6/07/2021
Date data sharing statement initially provided
6/07/2021
Date results provided
6/07/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Pain modulation characteristics in people with shoulder impingement and predictors of successful outcomes following physiotherapy treatment
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Scientific title
Pain modulation characteristics in people with shoulder impingement and predictors of successful outcomes following physiotherapy treatment
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Secondary ID [1]
286451
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None
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Universal Trial Number (UTN)
U1111-1168-8622
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
shoulder impingement
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Condition category
Condition code
Physical Medicine / Rehabilitation
294926
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0
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Physiotherapy
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Musculoskeletal
294983
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will receive a 30-minutes session per week for 4 weeks which includes mobilization-with-movement technique, taping for the shoulder and therapeutic exercises to improve scapular control, strengthen scapular stabilizers and rotator cuff muscles and stretch for the anterior and posterior shoulder and scapular elevator. Participants will be informed to perform the therapeutic exercises at home daily which will take around 30 minutes. A physiotherapist with more than 4 years of practice will administer the manual therapy and physiotherapy at the clinic as well as improve the exercises weekly at each appointment. A shoulder diary will be used to monitor adherence to the exercises performed at home and also to monitor pain scores during the 28-days protocol.
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Intervention code [1]
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Rehabilitation
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
Twenty-two age- and gender-matched healthy participants with no history of shoulder or neck pain or injury will also be recruited as control group. The control group will not receive any intervention since they are not shoulder pain patients.
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Control group
Active
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Outcomes
Primary outcome [1]
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Conditioned pain modulation (cold pressor test): Pressure pain threshold will be measured using the Somedic Digital Pressure algometer (Somedic AB, Farsta, Sweden) on the shoulder during the ice water bath applied on the opposite hand during 2 minutes.
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Assessment method [1]
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Timepoint [1]
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Patient group: 2 assessments on baseline performed with an interval of at least 48 hours between the measurements, and 1 assessment post-treatment (week 5).
Healthy group: 2 assessments on baseline performed with an interval of at least 48 hours between the measurements.
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Primary outcome [2]
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Thermal pain threshoulds (cold/heat): An electronic sensor (a small device 2 cm3 cube) will be placed over both shoulders and both knees using a velcro strap - TSA 2001-II (MEDOC).
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Assessment method [2]
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Timepoint [2]
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Patient group: 2 assessments on baseline performed with an interval of at least 48 hours between the measurements, and 1 assessment post-treatment (week 5).
Healthy group: 2 assessments on baseline performed with an interval of at least 48 hours between the measurements.
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Primary outcome [3]
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Temporal summation of pain (TS) using the 180 gr von Frey filament (North Coast Medical, San Jose, California) over both shoulder and both knees. Perceived pain intensity (in a 0-100 numerical rating scale) of a single pinprick stimulus will be compared with that of a series of 10 repetitive pinprick stimuli of the same physical intensity (1/s applied within an area of 1cm2).
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Assessment method [3]
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Timepoint [3]
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Patient group: 2 assessments on baseline performed with an interval of at least 48 hours between the measurements, and 1 assessment post-treatment (week 5).
Healthy group: 2 assessments on baseline performed with an interval of at least 48 hours between the measurements.
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Secondary outcome [1]
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Shoulder pain and disability index (SPADI)
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Assessment method [1]
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Timepoint [1]
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Patient group: 1 assessment on baseline and 1 assessment post-treatment (week 5).
Healthy group: 1 assessments on baseline.
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Secondary outcome [2]
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Depression, anxiety and stress scale (DASS)
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Assessment method [2]
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Timepoint [2]
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Patient group: 1 assessment on baseline and 1 assessment post-treatment (week 5).
Healthy group: 1 assessments on baseline.
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Secondary outcome [3]
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Quality of life (EuroQol questionnaire)
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Assessment method [3]
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Timepoint [3]
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Patient group: 1 assessment on baseline and 1 assessment post-treatment (week 5).
Healthy group: 1 assessments on baseline.
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Eligibility
Key inclusion criteria
Shoulder pain in the anterosuperior aspect of the shoulder for longer than 6 weeks, and classified with shoulder impingement with at least 3 of the following findings: positive Neer impingement test, positive Hawkins-Kennedy test, positive Jobe test, pain with passive or isometric resisted shoulder lateral rotation, pain with active shoulder elevation, pain with palpation of rotator cuff tendons, and pain in the C5 or C6 dermatome region.
Healthy subjects: no history of shoulder or neck pain or injury; no history of any kind of chronic pain.
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
History of cancer, previous fractures of the shoulder complex, recent shoulder surgery, corticosteroid injection into the glenohumeral joint within the previous 6 months, any neurological or auto-immune disorder, any recent shoulder dislocation, or if the shoulder pain was considered to be cervical in origin, history of fainting, dizziness, lightheadedness, chest pain or shortness of breath, or any history of cardiac disease.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
There is just one treatment for shoulder pain patients, therefore just one group of subjects treated which will be compared with healthy subjects. The purpose of the study are to characterise the sensory profile of subjects with shoulder impingment and to identify predictors for the success of the treatment based on the pain profile of the patient.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
There is no comparable data from people with shoulder pain on which to base our sample size. Based on similar work in whiplash, 22 participants with shoulder pain and 22 age- and sex-matched healthy controls will be recruited. Sample size was calculated based on a power analysis (0.80), and the assumption of a 2.1 degrees Celsius (SD 2.4) difference in CPM functioning between groups.
Paired sample t-tests will be used to compare within-subject differences in CPM measured at 30- and 60-seconds after the cold pressor test. Reliability of measures for each group will be assessed using intraclass correlation coefficients (ICC 3,1). To compare differences between shoulder pain and control groups at baseline, Wilcoxon signed rank test will be used for measurements with skewed distributions or one-way ANOVA for equal distributions (HPT, CPT, PPT, cold pressor test and TS). Linear correlations will be performed to assess predictor factors for the successful treatment.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
23/02/2015
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Actual
23/02/2015
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Date of last participant enrolment
Anticipated
27/04/2015
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Actual
6/04/2015
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Date of last data collection
Anticipated
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Actual
1/05/2015
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Sample size
Target
46
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Accrual to date
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Final
46
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Fundacao de Amparo a Pesquisa do Estado de Sao Paulo
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Address [1]
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R. Pio XI, 1500
Alto da Lapa
CEP 05468-901 Sao Paulo/SP
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Country [1]
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Brazil
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Primary sponsor type
University
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Name
Griffith University
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Address
GRIFFITH UNIVERSITY
Parklands Drive
Southport, QLD 4222
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Country
Australia
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Secondary sponsor category [1]
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Charities/Societies/Foundations
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Name [1]
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Fundacao de Amparo a Pesquisa do Estado de Sao Paulo
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Address [1]
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R. Pio XI, 1500
Alto da Lapa
CEP 05468-901 Sao Paulo/SP
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Country [1]
289696
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Brazil
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Griffith University Human Research Ethics Commitee
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Ethics committee address [1]
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Office for Research Gold Coast campus Room 4.25, The Learning Commons Building (G11) Griffith University Parklands Drive, Southport QLD 4215
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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26/11/2014
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Approval date [1]
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14/01/2015
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Ethics approval number [1]
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AHS/65/14/HREC
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Summary
Brief summary
There is a growing body of evidence of altered sensory processing in people with shoulder pain however it is not known which pain modulation pathway is affected in this population. It has also been reported that manual therapy techniques for the shoulder complex improve outcomes in patients with shoulder impingement compared to standard physiotherapy, sham or control interventions; however some findings suggest that a subgroup of individuals with shoulder pain may exist who will respond dramatically to these interventions. The aims of this study are to determine 1) the dominant pain modulation process in shoulder impingement individuals and 2) prognostic factors from the history, physical examination and pain modulation process in individuals with shoulder impingement who are likely to experience improvements following physiotherapy associated with manual therapy techniques. In this instance the population will be individuals with shoulder impingement symptoms and healthy controls. For the first aim of the study, all the subjects will be assessed twice at the baseline, with an interval of 48 hours between the measurements. For the second aim of the study, subjects with shoulder impingement will be treated during 4 weeks with manual therapy, physiotherapy and, when necessary, shoulder taping, and then reassessed after the 4-weeks rehabilitation program. The primary outcome measures will be heat pain threshold, cold pain threshold, cold pressor threshold, conditioned pain modulation and temporal summation of pain. The results of this study will contribute to our understanding of the dominant pain modulation process as mechanism for success in this technique and to guide physical therapists in selecting which patients with shoulder pain may experience improved outcomes following physiotherapy and manual therapy treatment. To date no scientific study has been conducted to investigate the pain modulation pathways in this population neither the predictive factors for successful outcomes concerning pain modulation in people with shoulder pain.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mrs Melina Nevoeiro Haik
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Address
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PhD student at Griffith University
8 Gurrah avenue
Southport, QLD 4215.
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Country
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Australia
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Phone
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+61 0402553515
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Melina Nevoeiro Haik
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Address
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PhD student at Griffith University
8 Gurrah avenue
Southport, QLD 4215.
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Country
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Australia
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Phone
56175
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+61 0402553515
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Leanne Bisset
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Address
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Leanne Bisset PhD
Musculoskeletal Physiotherapist
Senior Lecturer
Office: G01 room 1.08
Menzies Health Institute Qld
Centre for Musculoskeletal Research
School of Allied Health Science
Griffith University
Parklands Drive
4215
Southport, Qld
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Country
56176
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Australia
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Phone
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+617-55527717
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
measures of pain modulation.
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When will data be available (start and end dates)?
Any time. There is no end date of the availability of the data when asking for that by emailing the corresponding author.
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Available to whom?
To whom it may concern.
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Available for what types of analyses?
Any kind of analysis.
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How or where can data be obtained?
By e-mail (corresponding author):
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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