Thoracic Manipulation Versus Myofascial Release in Patients With Shoulder Impingement Syndrome

Not Applicable

• Conditions: Impingement Shoulder

• Registration Number: NCT05104671
• Lead Sponsor: manar sameh el taher

Brief Summary

aims: • To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on pain intensity.

* To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on pain pressure threshold.

* To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on shoulder proprioception.

* To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on shoulder range of motion(ROM).

* To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on disability of shoulder and hand questionnaire(DASH).

Detailed Description

Various researches have been done on rehabilitation of shoulder impingement by addressing either osseous structure or myofascial structure and found to be effective. But no studies could retrieve to compare these two: myofascial release and thoracic manipulation. (Dash \& Deepak, 2020). so in this study we will investigate the effect of adding thoracic manipulation versus myofascial release in patients with shoulder impingement syndrome. we will investigate the effect on each of the following: pain intensity will measure by visual analogue scale.(VAS).

proprioception of the shoulder by isokinetic dynamometer. pain pressure threshold by algometer. function by DASH questionnaire and finally ROM by kinovea software.

The subjects will be arranged into three groups: Group I (control group) will receive scapular stabilization exercises.

* Group II will receive scapular stabilization exercises and thoracic manipulation combined with shoulder mobilization.

* Group III will receive scapular stabilization exercises and myofascial release by instrument assisted soft tissue mobilization techniques(IASTM).

the measurements will take before and after treatment programs and after one month of follow up.

Study Timeline

• Study First Submitted: 2021-07-18
• Study First Submitted QC: 2021-10-21
• Study First Posted: 2021-11-03
• Study Start: 2021-12-01
• Status Verified: 2022-08
• Primary Completion: 2022-08-15
• Last Update Submitted: 2022-08-22
• Last Update Posted: 2022-08-25
• Study Completion: 2022-09-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

1. Sixty patients with shoulder impingement syndrome from both genders their age will be ranged and divided into three groups from 25-40 years.
2. History of shoulder pain for at least one month.
3. Positive Neer's impingement test and Hawkins's kiennedy test.
4. Presence of thoracic hypomobility from clinical evaluation.
5. Provocation of pain above 60 degrees of flexion and abduction.
6. Palpable trigger points on shoulder muscles.

Exclusion Criteria

1. History of Shoulder girdle fracture, dislocation and surgery
2. Diagnosed with frozen shoulder or rotator cuff tear
3. History of cervicobrachial pain
4. Any neuromuscular pain in upper limb and use of corticosteroids or pain subsiding medication

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Pain in shoulder movement	change from max pain point at 2 months	will be measured by Visual analog scale(VAS). It consists of a line, often 10 cm long(100mm); its ends are generally labelled with verbal pain anchors (e.g., "no pain" and "pain as bad as it could be"). Patients are asked to indicate the point along the line that best reflects their pain intensity. The majority of the studies showed that visual analogue scale is a valid and reliable scale. Also, it is an interval scale. So, in clinical practice we can use this scale in case of pain measurement as an outcome measure tool.
Shoulder Proprioception (joint of position error)	change from poor proprioception at 2 months	will be measured by isokinetic dynamometer. Isokinetic dynamometry is considered a valid instrument for assessing muscle strength, and it is often used as a reference standard for other strength assessments.
shoulder function	change from limitation of function at 2 months	by DASH is a reliable and valid tool for the assessment of shoulder pain and disability in both clinical practice and research.

Secondary Outcome Measures

Name	Time	Method
Shoulder ROM	change from limitation in shoulder ROM at 2 months	will be measured by Kinovea. Kinovea is a free software used for the analysis, comparison, and evaluation of sports and training. it is a reliable tool for measuring shoulder flexion, abduction, and Internal rotation\&external rotation in healthy individuals. Thus, it could be used as a simple alternative to universal goniometry.
Pain pressure threshold in shoulder muscles	change from baseline pain pressure threshold at 2 months	that Pressure algometer is a worthwhile tool in the diagnosis and treatment evaluation of different orthopedic disorders. . Three consecutive Pressure pain threshold measurements were taken at each point with 20 s rest between measurements, and the mean of the three trials will be used for analysis.

Trial Locations

Locations (1)

Cairo University; 🇪🇬 Cairo, Egypt