Scapular Upward Rotation Focused Treatment for Patients With Shoulder Impingement Syndrome and a Positive Scapular Assistance Test
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Disability of the Arm, Shoulder and Hand (DASH) questionnaire
研究概览
简要总结
Altered scapular movement is a common impairment among patients with subacromial impingement syndrome (SAIS). Nevertheless scapular focused interventions have resulted in conflicting findings among this population. One possible reason for this is the inability to identify patients with SAIS who will respond favorably to a scapular focused intervention.
The scapular assistance test (SAT) may be one possible indicator of patients most likely to benefit from a scapular focused intervention, particularly one that emphasizes scapular upward rotation. The purpose of this study is to examine targeted upward rotation intervention in patients demonstrating a positive Scapular Assistance test.
详细描述
Background: Patients with SAIS are commonly referred to physical therapy. A common impairment among patients with SAIS is altered scapular movement, characterized by insufficient upward rotation and posterior tilt. These deficits are believed to decrease the subacromial space and diminish length -tension relationship among the deltoid and rotator cuff musculature. The scapular assistance test (SAT) is a physical examination manoeuvre aimed to detect patients in whom insufficient scapular upward rotation and posterior tilt contribute to the generation of shoulder symptoms. The SAT may, therefore, serve as an indication for the need of scapular focused intervention. Given the inconsistent results of scapular focused interventions among patients with SAIS, the purpose of this study is to assess the outcome of a scapular-focused intervention, particularly geared toward increasing scapular upward rotation, among patients with SAIS that exhibit a positive SAT as well.
Methods: Fifty patients with SAIS and a positive SAT referred to the "Meuhedet" outpatient physical therapy clinic in Ashdod will be recruited for this study. Following baseline assessment, patients will be randomized into 12 sessions over a 6-week period. The intervention group will receive manual therapy and an exercise program focused on increasing scapular upward rotation while the control group will receive manual therapy and an exercise program focused on scapular muscle an rotator cuff strengthening with no special emphasis on scapular upward rotation. Repeated measures analysis of covariance will be conducted to detect differences in pain intensity, shoulder -related disability and scapular upward rotation following the intervention
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)
盲法说明
We assume participants will not be able to differentiate between the upward rotation focused intervention and the control intervention. Furthermore, the examiner performing baseline and outcome assessment will be unaware of the group allocation while performing these assessments.
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Unilateral shoulder pain for ≥1 month
- •A diagnosis of SAIS as determined by having 3 or ore positive tests out of: Neer test, Hawkins test, Painful arc, Jobe test, external rotation resistance test.
- •A positive SAT
排除标准
- •Cervical spine involvement as evidenced by reproduction of symptoms with neck movement
- •Massive rotator cuff tear as evidenced by pseudoparalysis
- •Previous history of a fracture or surgery within the involved shoulder.
- •Limited passive range of motion by ≥50% or more compared with uninvolved side in
- •2 planes of motion (i.e. flexion, external rotation)
- •A history of shoulder dislocation or subluxation
- •A history of Rheumatoid arthritis, CVA, fibromyalgia
- •Current pregnancy
- •Population with special needs
- •Pending disability claim / litigation procedure associated with shoulder complaint.
结局指标
主要结局
Disability of the Arm, Shoulder and Hand (DASH) questionnaire
时间窗: pre intervention
each participant will receive the Disability of the Arm shoulder and hand questioner. score is from 0 -100 a higher score is greater disability
Numeric pain Rating Scale (NPRS), 0 - 10
时间窗: pre intervention
each participant will receive the NPRS questioner higher score means greater pain
次要结局
- scapular posterior tilt(pre intervention)
- Active shoulder flexion(pre intervention)
- active shoulder abduction(pre intervention)