Exercise Training Sequence for Subacromial Impingement Syndrome

Not Applicable

Completed

• Conditions: Subacromial Impingement Syndrome
• Interventions: Other: Scapular Training; Other: Rotator Cuff Training

• Registration Number: NCT02478567
• Lead Sponsor: University of Texas Southwestern Medical Center

Brief Summary

Randomized crossover trial evaluating the impact of exercise training sequence of axioscapular and rotator cuff exercises in patients diagnosed with subacromial impingement syndrome.

Detailed Description

While physical therapy is an effective element in the rehabilitation of rotator cuff (RC) disease, the most effective sequence of training interventions has not been defined. The purpose of this study is to determine if there is a difference in pain or function in patients who are given RC strengthening prior to or after initiating scapular stabilization exercises.

The study was a prospective randomized crossover design. 26 men and 14 women, mean age 51, diagnosed with subacromial impingement syndrome (SAIS) were randomly assigned to one of two groups for a comprehensive and standardized rehabilitation program over six visits at an orthopedic outpatient clinic. One group was prescribed a 4-week program of scapular stabilization exercises while the other group began with RC strengthening exercises. The crossover design had each group add the previously excluded four exercises to their second month of rehabilitation.

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study Start: 2012-08
• Primary Completion: 2014-08
• Study Completion: 2015-01
• Study First Submitted: 2015-06-16
• Study First Submitted QC: 2015-06-17
• Study First Posted: 2015-06-23
• Status Verified: 2016-05
• Last Update Submitted: 2016-05-14
• Last Update Posted: 2016-05-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

• 18-80 years of age
• diagnosis of Neer Stage I/II subacromial impingement with a primary pain complaint in the shoulder and/or upper arm
• presence of at least two of the following findings: painful arc, weakness in external rotation, positive impingement sign (Hawkins-Kennedy or Neer/Walsh tests), pain and/or weakness with resistance to internal rotation, external rotation, or scapular plane elevation.

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Exclusion Criteria

• concurrent medical co-morbidities including pregnancy, diabetes, and rheumatoid arthritis -
• osteoarthritis greater than grade 2 on the Kellgren-Lawrence scale
• current diagnosis and/or previous history of glenohumeral instability or dislocation
• full-thickness rotator cuff tear
• adhesive capsulitis
• fractures of the scapula, clavicle or humerus
• scapulothoracic or rotator cuff paresis
• shoulder surgery in past year
• inability to speak the English language at a level sufficient to obtain informed consent.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Scapular Training	Scapular Training	Initiated scapular training exercise for the first 4 weeks followed by addition of rotator cuff exercises the next four weeks
Rotator Cuff Training	Rotator Cuff Training	initiated rotator cuff training exercise for the first 4 weeks followed by addition of scapular training exercises the next four weeks.

Primary Outcome Measures

Name	Time	Method
Numeric Pain Score	16 weeks	pain levels
Global Rating of Change	16 weeks	patient satisfaction
American Shoulder Elbow Surgeon's Outcome Score	16 weeks	self-report of function
Global Percentage of Improvement	16 weeks	patient perception of status

Trial Locations

Locations (1)

UT Southwestern Medical Center; 🇺🇸 Dallas, Texas, United States