Effect of Isometric Exercise on Pain Perception in Rotator Cuff Related Shoulder Pain
- Conditions
- Rotator Cuff Tendinitis
- Interventions
- Other: Supra-threshold isometric exerciseOther: Infra-threshold isometric exercise
- Registration Number
- NCT03675399
- Lead Sponsor
- University of Valencia
- Brief Summary
The aim of this study is to compare the immediate effects of an acute bout of isometric exercise of the shoulder external rotator muscles above and below pain threshold on pain intensity, pain threshold, conditioned pain modulation and pain free force in external rotation. To evaluate the results of the exercise, the subjects will be assessed at pre-intervention, immediately post-intervention and after and 45 minutes after each experimental condition.
- Detailed Description
The aim of this study is to compare the immediate effects of an acute bout of isometric exercise of the shoulder external rotator muscles above and below pain threshold on pain intensity, pain threshold, conditioned pain modulation and pain free force in external rotation.
It will consist of a randomized three-treatment parallel-design study. The sample will consist of subjects with rotator cuff related shoulder pain (RCRSP). Once the sample is selected, subjects will participate in three experimental sessions, which will occur in a randomized order: two exercise sessions (supra-threshold and infra-threshold isometric exercise) and one control session. In the first session, information regarding clinical and demographical aspects will be collected. A washout period of approximately 48 hours will separate each of the experimental sessions.
To evaluate the results of the exercise, the subjects will be assessed at pre-intervention, immediately post-intervention and 45 minutes after each experimental condition. Pain intensity, Pressure Pain Thresholds (PPT), Conditioned Pain Modulation (CPM), maximal voluntary isometric contraction (MVIC) and pain free isometric strength (PFIS) will be measured.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 35
- aged 18-80 years (likelihood of patients > 80 having degenerative changes in the shoulder is increased)
- pain localised to the proximal anterolateral shoulder region
- positive for pain on at least one of the following three impingement tests: Hawkins-Kennedy, Neer's, Jobe's
- positive for pain on resisted external rotation and/or abduction.
- shoulder surgery within last 6 months
- reasons to suspect systemic pathology including inflammatory disorders, cervical repeated movement testing affects shoulder pain and/or range of movement, passive external rotation deficit greater (less than 30º or a range of motion reduction of 50% or more as compared to the contralateral side), upper limb tension test A for cervical radiculopathy
- atraumatic degenerative rotator cuff tear based on the cluster of clinical tests (painful arc, drop arm test, and marked weakness into ER all three positive)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Supra-threshold isometric exercise Supra-threshold isometric exercise Participants will perform 10 isometric external rotation supra-threshold contractions of the affected shoulder, each held for 15 seconds, with resting intervals of 15 seconds between contractions. Infra-threshold isometric exercise Infra-threshold isometric exercise Participants will perform 10 isometric external rotation infra-threshold contractions of the affected shoulder, each held for 15 seconds, with resting intervals of 15 seconds between contractions.
- Primary Outcome Measures
Name Time Method Pain intensity 45 minutes post-intervention Shoulder pain intensity reported by the patient will be assessed using a 100-mm visual analogue scale (VAS, 0-100, 0=minimum score, 100=maximum score). Lower values represent a better outcome (less pain).
- Secondary Outcome Measures
Name Time Method Maximal voluntary isometric contraction (MVIC) 45 minutes post-intervention MVIC will be measured at both m. infraspinatus and m. quadriceps of the non-affected side using a digital force gauge.
Conditioned pain modulation (CPM) 45 minutes post-intervention CPM will be tested using the upper extremity submaximal effort tourniquet test.
Pain free isometric strength/threshold (PFIS) 45 minutes post-intervention PFIS will be assessed at m. infraspinatus of the affected shoulder
Pressure Pain Thresholds (PPT) 45 minutes post-intervention PPTs will be recorded using an electronic algometer at the ipsilateral m. infraspinatus, the contralateral resting m. infraspinatus and the contralateral resting m. quadriceps. Higher values represent a better outcome.
Trial Locations
- Locations (1)
Mercè Balasch i Bernat
🇪🇸Valencia, Spain