The Effect of Strengthening Exercises for Humeral Head Depressor Muscles on Clinical Outcomes After Reverse Shoulder Arthroplasty
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 27
- 试验地点
- 1
- 主要终点
- Pain Intensity (Visual Analog Scale - VAS)
研究概览
简要总结
Postoperative rehabilitation after reverse shoulder arthroplasty aims to improve pain control, range of motion, and functional capacity. However, studies examining the effects of strengthening exercises targeting the humeral head depressor muscles are limited. This randomized controlled trial will evaluate the effects of adding a specific strengthening program to standard rehabilitation on pain, range of motion, quality of life, and functional outcomes.
详细描述
Reverse shoulder arthroplasty (RSA) is an effective surgical method, particularly in cases of massive rotator cuff tears that lead to irreversible loss of shoulder function. The primary goals of postoperative rehabilitation are to reduce pain, improve shoulder joint functions, optimize scapulothoracic rhythm, and safely restore functional use. However, studies examining the effects of specific strengthening exercises targeting the humeral head depressor muscle group (latissimus dorsi, teres major, infraspinatus, etc.) on clinical outcomes are quite limited. This study aims to evaluate the effects of a specific strengthening protocol designed for the humeral head depressor muscles following reverse shoulder arthroplasty on pain, range of motion (ROM), quality of life, functional status, and psychological well-being. Planned as a randomized controlled trial, the research will apply an additional humeral head depressor muscle strengthening program to the standard conventional rehabilitation protocol in the experimental group, while the control group will receive only the standard rehabilitation program.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
Blinded assessor
入排标准
- 年龄范围
- 65 Years 至 90 Years（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients scheduled for primary reverse total shoulder arthroplasty Intact teres minor confirmed by physical examination (Hornblower's test) and intraoperative assessment Ability to participate in physiotherapy or a home exercise program
排除标准
- •Active infection Deltoid muscle insufficiency Inability or unwillingness to comply with randomization Prior shoulder arthroplasty on the same side Unwillingness to participate Inability to read or understand written instructions
研究组 & 干预措施
Conventional Rehabilitation Group
Participants undergoing reverse shoulder arthroplasty will receive a standard conventional rehabilitation program starting at postoperative 6 th week . The patient will receive treatment 5 days a week for 6 weeks, for a total of 30 sessions. The program consists of passive, active-assisted, and active/resisted exercises.
Exercises Included:
Passive / Assisted
- Scapular mobilization
- Scapular clock
- Passive external rotation with a stick Passive → Active-Assisted
- Active-assisted flexion and abduction with a stick
- Glenohumeral joint mobilization Active / Light Resistance
- Scapular retraction
- Light-resistance strengthening of biceps, triceps, and serratus anterior using a theraband Active / Resistance
- Theraband-based resisted biceps, triceps, and serratus anterior strengthening
- Continuation of glenohumeral mobilization
- Flexion and abduction above 90°
- Posterior capsule stretching
干预措施: Conventional Rehabilitation Group (Other)
Depressor Muscle Strengthening Program
Participants will receive specific strengthening exercises targeting the shoulder depressor muscles in addition to the conventional rehabilitation program. These exercises will be performed throughout the 6-week intervention period.
Additional Exercises:
Latissimus dorsi: Seated rowing exercise - 3 sets × 10 repetitions Pectoralis major: Supine fly exercise - 3 sets × 10 repetitions Teres major: Prone shoulder adduction, extension, and internal rotation exercise
干预措施: Conventional Rehabilitation Group (Other)
Depressor Muscle Strengthening Program
Participants will receive specific strengthening exercises targeting the shoulder depressor muscles in addition to the conventional rehabilitation program. These exercises will be performed throughout the 6-week intervention period.
Additional Exercises:
Latissimus dorsi: Seated rowing exercise - 3 sets × 10 repetitions Pectoralis major: Supine fly exercise - 3 sets × 10 repetitions Teres major: Prone shoulder adduction, extension, and internal rotation exercise
干预措施: Depressor Muscle Strengthening Group (Other)
结局指标
主要结局
Pain Intensity (Visual Analog Scale - VAS)
时间窗: 6 weeks
Pain intensity will be assessed using the Visual Analog Scale, a 10-cm line ranging from "no pain" to "worst imaginable pain." The distance from the "no pain" anchor to the participant's mark will be measured in millimeters (0-100 mm), with higher scores indicating higher pain intensity.
Upper Extremity Disability (Disabilities of the Arm, Shoulder and Hand Questionnaire - DASH)
时间窗: 6 weeks
The DASH is a 30-item self-administered questionnaire assessing upper-extremity functional limitations. Items are scored 1-5 and converted to a 0-100 scale, where higher scores indicate greater disability.
Shoulder Range of Motion (ROM)
时间窗: 6 weeks
Active shoulder flexion, abduction, external rotation, and internal rotation will be measured using a standard goniometer. Results will be recorded in degrees (°).
次要结局
- Shoulder Function (American Shoulder and Elbow Surgeons Score - ASES)(6 weeks)
- Thoracic Kyphosis Angle (Spinal Mouse Assessment)(6 weeks)
- Pain Catastrophizing (Pain Catastrophizing Scale - PCS)(6 weeks)
- Anxiety and Depression (Hospital Anxiety and Depression Scale - HADS)(6 weeks)
- Kinesiophobia (Tampa Scale of Kinesiophobia - TSK)(6 weeks)
- Quality of Life (12-Item Short-Form Health Survey - SF-12)(6 weeks)
研究者
Caner Karartı
Principal Investigator
Hacettepe University