Background Corticosteroid injections and physiotherapy exercise programmes are commonly used to treat rotator cuff disorders but the treatments' effectiveness is uncertain. We aimed to compare the clinical effectiveness and costeffectiveness of a progressive exercise programme with a single session of best practice physiotherapy advice, with or without corticosteroid injection, in adults with a rotator cuff disorder.Methods In this pragmatic, multicentre, superiority, randomised controlled trial (2 × 2 factorial), we recruited patients from 20 UK National Health Service trusts. We included patients aged 18 years or older with a rotator cuff disorder (new episode within the past 6 months). Patients were excluded if they had a history of significant shoulder trauma (eg, dislocation, fracture, or full-thickness tear requiring surgery), neurological disease affecting the shoulder, other shoulder conditions (eg, inflammatory arthritis, frozen shoulder, or glenohumeral joint instability), received corticosteroid injection or physiotherapy for shoulder pain in the past 6 months, or were being considered for surgery. Patients were randomly assigned (centralised computer-generated system, 1:1:1:1) to progressive exercise (≤6 sessions), best practice advice (one session), corticosteroid injection then progressive exercise, or corticosteroid injection then best practice advice. The primary outcome was the Shoulder Pain and Disability Index (SPADI) score over 12 months, analysed on an intention-to-treat basis (statistical significance set at 1%). The trial was registered with the International Standard Randomised Controlled Trial Register, ISRCTN16539266, and EuDRACT, 2016-002991-28.Findings Between March 10, 2017, and May 2, 2019, we screened 2287 patients. 708 patients were randomly assigned to progressive exercise (n=174), best practice advice (n=174), corticosteroid injection then progressive exercise (n=182), or corticosteroid injection then best practice advice (n=178). Over 12 months, SPADI data were available for 166 (95%) patients in the progressive exercise group, 164 (94%) in the best practice advice group, 177 (97%) in the corticosteroid injection then progressive exercise group, and 175 (98%) in the corticosteroid injection then best practice advice group. We found no evidence of a difference in SPADI score between progressive exercise and best practice advice when analysed over 12 months (adjusted mean difference -0•66 [99% CI -4•52 to 3•20]). We also found no evidence of a difference between corticosteroid injection compared with no injection when analysed over 12 months (-1•11 [-4•47 to 2•26]). No serious adverse events were reported.Interpretation Progressive exercise was not superior to a best practice advice session with a physiotherapist in improving shoulder pain and function. Subacromial corticosteroid injection provided no long-term benefit in patients with rotator cuff disorders.

Beliefs about gender appropriateness and conceptions of ability have been identified as powerful influences on beliefs about competence. The purpose of this study was to investigate the interaction of those two factors on competence beliefs in physical activity. Participants completed a survey about the sport of hockey, watched a video of a specific hockey skill, and then responded to questions about the skill. Males expressed more confidence in their ability to learn hockey than females, but females who perceived the activity to be gender neutral were more confident in their ability to learn hockey than females who believed the activity was predominantly for males. Participants’ explanations of their beliefs about gender appropriateness and confidence shed light on how competence beliefs are affected by perceptions of gender appropriateness and conceptions of ability.

ABSTRACT

Five classes of Art Appreciation first semester undergraduate Hispanic students assigned to one professor were selected to experience cooperative learning over a full semester. Pre-semester surveys and post-semester surveys were completed by 104 Hispanic freshmen college students. Strategies used in the classes included Think-Pair-Share, Ticket Out the Door, Jigsaw and being a member of base groups of two. This study is based upon theories of social interdependence, cognitive development, and behavioral learning. The surveys were completed by the first time college freshmen to compare and contrast knowledge about their experiences in: 1) individual learning, and 2) learning with a partner.