Blood Flow - an Underlying Mechanism Behind Clinical Improvements in Patients With Subacromial Pain Syndrome?
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 24
- Locations
- 1
- Primary Endpoint
- Time to exhaustion, incremental test
Study Overview
Brief Summary
The purpose of this randomized clinical trial is two-fold. Firstly to see if patients suffering Subacromial Pain Syndrome can improve blood flow in the supraspinatus muscle in their shoulder, and secondly to investigate how changes in this blood flow are related to pain experience and shoulder function.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 70 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •shoulder pain for longer than three months
- •clinical findings indicative of subacromial pain syndrome (evaluated by Hawkins-Kennedy sign, Neers sign, painful arch and Yokum test)
- •normal passive range of motion of the shoulder
Exclusion Criteria
- •subjects unable to provide an informed consent
- •lack of ability to complete the intervention
- •full rupture of the tendon of m. supraspinatus
- •planned shoulder surgery, or previous shoulder surgery on affected shoulder
- •other musculoskeletal problem that could explain the symptoms
- •adhesive capsulitis
- •pregnancy
- •rheumatoid arthritis
- •symptomatic osteoarthritis of the shoulder/shoulder girdle
- •glenohumeral instability
- •widespread pain syndrome
- •unstable underlying heart disease
- •cortisone injections in the shoulder the last month
- •allergies
- •other serious mental or somatic disease (i.e. psychosis or active cancer disease).
Arms & Interventions
Intervention group
The subjects in this arm will receive four high intensity (80% of peak work rate) four-minute interval exercises for the abduction movement in the plane of the scapula (m. supraspinatus), supervised three times per week. In addition they will perform the exercise program described for the control group.
Intervention: Exercise: local high intensity interval exercise (Other)
Control group
The control group will receive a best clinical practice home-exercise program, with regular follow-ups at the shoulder clinic every other week. The details are described in Granviken et al. (2015).
Intervention: Exercise: best clinical practice (Other)
Outcomes
Primary Outcomes
Time to exhaustion, incremental test
Time Frame: Week 0
participants abduct their shoulder up to 90 degrees in scapula's plane (scapularization) at a frequency of 0,5 Hz. Every minute the load is increased with 250 grams. The test is stopped if participant fails to maintain pace or movement quality, or experiences increased pain. Time at failure is noted as the result.
Secondary Outcomes
- Affected shoulder(Week 0)
- Duration of symptoms(Week 0)
- Age(Week 0)
- 1 repetition maximum (1RM), bilateral shoulder test(Week 8)
- SPADI questionnaire(Pre+post-test (8 weeks in-between))
- Weight(Week 0)
- Height(Week 0)
- Socioeconomic status(Week 0)
- Time to exhaustion, steady state(Week 8)
- Regional blood flow in m. supraspinatus, using contrast enhanced ultrasound (concentration of white analyzed as decibels in region of interest)(Week 8)