The Effectiveness of Graded Motor Imagery Therapy Applied in Addition to the Traditional Physiotherapy Program in Shoulder Impingement Syndrome
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 30
- 试验地点
- 2
- 主要终点
- Global Rating of Change scale (Patient Satisfaction)
研究概览
简要总结
Graded motor imagery (GMI): used successfully in chronic, complex and painful clinical conditions accompanied by many pain and movement problems; It is a treatment, education and rehabilitation process that is based on recently obtained scientific data and current clinical studies, is individually adapted and approaches the individual holistically with a biopsychosocial model. Nowadays, it is frequently used in the treatment of some neurological diseases. In addition, these approaches are also used in the treatment of some orthopedic diseases including chronic pain. There are a limited number of studies in which the mentioned approaches are used together in stages, and the stages are mostly used alone. There is only one study in the literature on subacromial pain syndrome (SAS), which is the most common cause of shoulder pain and causes radiator cuff problems. Stage 2 SAS patients were included in the study and only one phase of GMI treatment was used in addition to the traditional physiotherapy program. Despite these positive results in favor of GMI, the fact that there is no study using the entire GMI treatment in SAS shows us that a randomized controlled and blinded study with high evidence value should be conducted on this subject. In addition, determining the effect of GMI on changes in central nervous system such as fear of pain, two-point discrimination, and left/right lateralization speed and accuracy task will help fill the literature gaps on this subject. In the light of this information, the question of planned master's thesis study is the effect of GMI treatment applied in addition to traditional physiotherapy in SAS on pain level, joint range of motion, functionality, pain-related fear, two-point discrimination and left/right lateralization speed and accuracy compared to only traditional physiotherapy. whether it is superior or not.
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
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 20 Years 至 50 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •20-50 years of age with complaints of shoulder pain in the anterio-lateral region lasting more than 6 weeks, with a positive Neer impingement test and/or a positive Hawkins-Kennedy test
- •Additionally, patients must have at least one of the symptoms listed. These symptoms are: painful arch on active shoulder elevation, pain with resisted shoulder external rotation in abduction at 90°, and a positive empty can test.
排除标准
- •Having had a steroid injection into the shoulder within the last 3 months
- •Previous surgery on the neck, thoracic spine or shoulder
- •Red flags (e.g. tumor, fracture, metabolic diseases, rheumatoid arthritis, osteoporosis, resting blood pressure greater than 140/90 mmHg, history of long-term steroid use)
- •History of shoulder dislocation, subluxation, fracture, adhesive capsulitis, frozen shoulder, or cervical or thoracic surgery
- •History of full-thickness rotator cuff tear
- •History of cervical disc herniation in the last 6 weeks
- •History of breast cancer on the involved side
- •Isolated acromioclavicular joint pathology (i.e., pain directly localized over the acromioclavicular joint).
- •Signs of cervical radiculopathy, radiculitis, or referred pain originating from the cervical spine
- •Receiving treatment for shoulder pain in the last 3 months
- •Being currently pregnant (Dunning, 2022)
- •Scoring ≤24 on the Standardized Mini Mental Test was determined.
研究组 & 干预措施
Traditional Physiotherapy Program
This group included strengthening exercises will be applied, including various joint movements and strengthening exercises applied in physiotherapy clinics.
干预措施: Traditional Physiotherapy Program (Other)
Traditional Physiotherapy Program and Graded Motor Imagery Therapy
The three different treatment techniques include left/right discrimination training, explicit motor imagery exercises and mirror therapy. These techniques are delivered sequentially but require a flexible approach from the patient and clinician to move forwards, backward and sideways in the treatment process to suit the individual. With patience, persistence and often lots of hard work, GMI gives new hope for treatment outcomes.
干预措施: Graded Motor Imagery (Other)
Traditional Physiotherapy Program and Graded Motor Imagery Therapy
The three different treatment techniques include left/right discrimination training, explicit motor imagery exercises and mirror therapy. These techniques are delivered sequentially but require a flexible approach from the patient and clinician to move forwards, backward and sideways in the treatment process to suit the individual. With patience, persistence and often lots of hard work, GMI gives new hope for treatment outcomes.
干预措施: Traditional Physiotherapy Program (Other)
结局指标
主要结局
Global Rating of Change scale (Patient Satisfaction)
时间窗: Change from baseline Global Rating of Change scale at 6th week
Patient satisfaction regarding improvement in shoulder function will be evaluated by the Global Rating of Change scale. All participants will be asked to rate their condition after a six-week intervention period compared to baseline by indicating whether they have improved significantly, improved slightly, unchanged, deteriorated slightly, or deteriorated significantly between -3 to +3, with a higher value indicating better condition in this study.
Central Sensitization Scale
时间窗: Change from baseline score of Central Sensitization Scale scale at 6th week
Central Sensitization Scale, which can be applied in the presence of chronic pain, is used in central sensitization syndromes. It consists of two parts. Part A of the scale includes a Likert scale (0-4 points) that questions health-related symptoms. This section is scored from 0 to 100, with higher numbers being associated with a higher degree of central sensitization. Scores of 40 and above indicate the presence of central sensitization. In section B, it questions whether any of the central sensitization syndromes have been diagnosed before.
The Numerical Rating Scale (NPRS-11)
时间窗: Change from baseline range of motion at 6th week
The Numerical Rating Scale (NPRS-11) is an 11-point scale for self-report of pain. It is the most commonly used unidimensional pain scale. The respondent selects a whole number (integers 0-10) that best reflects the intensity (or other quality if requested of his/her pain.0 point is the minimum and 10 point is the maximum. The higher the score, the more severe the pain.
The Shoulder Pain and Disability Index
时间窗: Change from baseline score of The Shoulder Pain and Disability Index at 6th week
The Shoulder Pain and Disability Index (SPADI) was developed to measure current shoulder pain and disability in an outpatient setting. The SPADI contains 13 items that assess two domains; a 5-item subscale that measures pain and an 8-item subscale that measures disability between 0 to 100, with a higher value indicating worse condition.
次要结局
- Left/right discrimination (Lateralization)(Change from baseline Left/right discrimination at 6th week)
- Pressure Pain Threshold(Change from baseline Pressure Pain Threshold at 6th week)
- Range of motion(Change from baseline range of motion at 6th week)
- Pain Catastrophizing Scale(Change from baseline score of Pain Catastrophizing Scale at 6th week)
- Kinesthetic and Visual Imagery Questionnaire (KVIQ)(Change from baseline Kinesthetic and Visual Imagery Questionnaire at 6th week)
- Fear avoidance belief questionnaire (FABQ)(Change from baseline score of Fear avoidance belief questionnaire at 6th week)
- The two-point discrimination test(Change from baseline two-point discrimination at 6th week)
研究者
Nuray Alaca
Assoc. Prof. Nuray Alaca, Head of Physiotherapy and Rehabilitation Department
Acibadem University