Neurophysiology of Weakness and Exercise in Rotator Cuff Tendinopathy
- Conditions
- Acute PainAtrophicInfiltrationMuscle WeaknessPathologyGoalsImpairmentShoulder PainTendinopathySyndrome
- Interventions
- Procedure: Subacromial injectionOther: Physical Therapy
- Registration Number
- NCT02971072
- Lead Sponsor
- University of Oregon
- Brief Summary
The purpose of this study is to examine deficits in activation and motor patterns, as well as central drive in patients with rotator cuff tendinopathy. There are three specific aims: (1) determine the effect of acute pain relief on rotator cuff muscle activation in patients with rotator cuff tendinopathy, (2) determine the effect of exercise on rotator cuff muscle activation in patients with rotator cuff tendinopathy, and (3) compare rotator cuff muscle activation between patients with rotator cuff tendinopathy and healthy controls.
- Detailed Description
The long-term goal of our research agenda is to identify the mechanisms associated with rotator cuff tendinopathy (impingement syndrome) and subsequently evaluate novel treatment strategies that address these mechanisms. The objectives of this application are to study the muscle patterns in patients with rotator cuff tendinopathy as well as the effects of both pain and exercise on these patterns. Our first hypothesis is that pain relief from a shoulder injection will result in increased rotator cuff activity. Our second hypothesis is that patients with tendinopathy will demonstrate improved rotator cuff muscle activity following a six-week exercise program and that this improvement will be higher in patients that respond favorably to treatment. Our final hypothesis is that patients with cuff tendinopathy will show decreased rotator cuff activity compared to healthy subjects. The investigators plan on addressing these hypotheses using several novel techniques for muscle activity assessment.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 180
- pain with passive provocative maneuvers (positive Hawkins or Neer test)
- pain with active elevation (positive painful arc)
- pain with isometric resisted movements (Jobe's "empty can" test or resisted shoulder external rotation with the arm at the side)
- demonstrate weakness (>10% force deficit in external rotation)
Patient
- shoulder surgery on the symptomatic side
- positive Spurling test
- traumatic shoulder dislocation or instability in the past 3 months
- reproduction of shoulder pain with active or passive cervical range of motion
- signs of rotator cuff tear (drop-arm test, lag signs, gross external rotation weakness, or positive image findings)
- current musculoskeletal, neurologic or cardiovascular compromise
Control Inclusion Criteria:
- no current or previous shoulder injury
- matched for age (within 5 years) and sex
- meet Patient Exclusion Criteria (minus musculoskeletal, neurologic, or cardiovascular compromise)
Control Exclusion Criteria:
- pain with active arm elevation
- positive Hawkins, Neer, or Jobe's test
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Patients Subacromial injection Subjects with shoulder tendinopathy who will undergo both a subacromial injection and physical therapy Patients Physical Therapy Subjects with shoulder tendinopathy who will undergo both a subacromial injection and physical therapy
- Primary Outcome Measures
Name Time Method Rotator cuff activation after subacromial injection and exercise intervention, difference in specific rotator cuff muscle activation between subjects and controls 6 weeks Assessed using electromyography (EMG)
Rotator cuff activation after subacromial injection and exercise intervention, difference in rotator cuff voluntary activation between subjects and controls 6 weeks Assessed using voluntary activation
- Secondary Outcome Measures
Name Time Method Rotator cuff voluntary activation after subacromial injection 2 hours Assessed using voluntary activation
Rotator cuff voluntary activation correlations with pain levels 2 hours Assessed using voluntary activation relative to self-reported pain level
Rotator cuff muscle activation correlation with improvements in clinical outcome measures 6 weeks Assessed using EMG relative to changes in questionnaire scores
After both a subacromial injection and a six-week exercise program, differences in rotator cuff voluntary activation between patients and healthy controls 6 weeks Assessed using voluntary activation
After both a subacromial injection and a six-week exercise program, differences in rotator cuff muscle activation between patients and healthy controls 6 weeks Assessed using EMG
Rotator cuff muscle activation after subacromial injection 2 hours Assessed using EMG
Rotator cuff voluntary activation after 6-week exercise intervention and subacromial injection 6 weeks Assessed using voluntary activation
Rotator cuff muscle activation after 6-week exercise intervention and subacromial injection 6 weeks Assessed using EMG
Prior to treatment, rotator cuff voluntary activation in patients relative to healthy controls 6 weeks Assessed using voluntary activation
Rotator cuff activation correlations with pain levels 2 hours Assessed using EMG relative to self-reported pain level
Rotator cuff muscle activation correlation with improvements in pain relief 6 weeks Assessed using EMG relative to self-reported pain relief
Rotator cuff voluntary activation correlation with improvements in pain relief 6 weeks Assessed using voluntary activation relative to self-reported pain relief
Rotator cuff voluntary activation correlation with improvements in clinical outcome measures 6 weeks Assessed using voluntary activation relative to changes in questionnaire scores
Prior to treatment, rotator cuff muscle activation in patients relative to healthy controls 6 weeks Assessed using EMG
Trial Locations
- Locations (1)
University of Oregon
🇺🇸Eugene, Oregon, United States