The Effect of Graded Motor Imagery on Pain, Range of Motion, Kinesiophobia, Position Sense and Quality of Life in Shoulder Impingement Syndrome
Trial Snapshot
- Phase
- Not Applicable
- Status
- Active, not recruiting
- Sponsor
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Visual Analogue Scale
Study Overview
Brief Summary
Purpose: This randomized controlled trial aims to investigate the effects of Graded Motor Imagery (GMI) added to conventional physiotherapy in patients with Grade-2 shoulder impingement syndrome. The primary objectives are to evaluate the impact of GMI on pain intensity, range of motion, kinesiophobia, joint position sense, and quality of life. The hypotheses tested are:
H0: GMI combined with conventional therapy has no effect on the aforementioned outcomes.
H1: GMI combined with conventional therapy significantly improves these outcomes.
Methodology: The study will include 30 participants (15 control, 15 intervention) diagnosed with Grade-2 shoulder impingement, recruited from a tertiary hospital. Participants will be randomly allocated into two groups:
Control Group: Receives 15 sessions of conventional physiotherapy (ultrasound, TENS, hotpack, and therapeutic exercises).
Intervention Group: Receives conventional therapy plus GMI, which includes three phases: (1) lateralization training (identifying left/right limb images), (2) motor imagery (mental rehearsal of functional movements), and (3) mirror therapy (visual feedback via mirror).
Outcome measures include pain (Visual Analog Scale), range of motion (digital goniometer), joint position sense (mobile app-based assessment), kinesiophobia (Tampa Scale), upper extremity function (DASH questionnaire), and quality of life (SF-36). Pre- and post-intervention evaluations will be conducted.
Detailed Description
Purpose:
This study is designed as a randomized controlled trial to evaluate the effectiveness of Graded Motor Imagery (GMI) as an adjunct to conventional physiotherapy in patients diagnosed with Grade-2 shoulder impingement syndrome. The primary aim is to assess the impact of GMI on several key outcomes, including pain intensity, range of motion, kinesiophobia (fear of movement), joint position sense, and quality of life. The study is motivated by the need to explore innovative rehabilitation techniques that address both the physical and neurological aspects of shoulder impingement syndrome, particularly in cases where conventional treatments may not yield optimal results.
The study is guided by two hypotheses:
Null Hypothesis (H0): The addition of GMI to conventional physiotherapy has no significant effect on pain, range of motion, kinesiophobia, joint position sense, or quality of life in patients with Grade-2 shoulder impingement syndrome.
Alternative Hypothesis (H1): The addition of GMI to conventional physiotherapy significantly improves pain, range of motion, kinesiophobia, joint position sense, and quality of life in these patients.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Participant)
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •To be between the ages of 18-65,
- •Volunteering to participate in the study,
- •Diagnosed with Grade-2 shoulder impingement.
Exclusion Criteria
- •Not volunteering to participate in the study,
- •Having undergone upper extremity surgery,
- •History of previous shoulder surgery, shoulder subluxation or dislocation,
- •Any mental or sensory problems,
- •Acute infection or chronic disease of neurological, psychiatric, orthopedic, cardiological, rheumatological, etc. origin.
Arms & Interventions
Intervention
For patients diagnosed with shoulder impingemet, graded motor imagery will be applied in addition to 15 sessions of conventional treatment.
Intervention: Conventional treatment (Other)
Intervention
For patients diagnosed with shoulder impingemet, graded motor imagery will be applied in addition to 15 sessions of conventional treatment.
Intervention: Graded motor imagery (Other)
Control
Patients diagnosed with shoulder impingemet will receive 15 sessions of conventional treatment.
Intervention: Conventional treatment (Other)
Outcomes
Primary Outcomes
Visual Analogue Scale
Time Frame: 3 weeks
In this study, the severity of shoulder pain will be evaluated with the Visual Analogue Scale. According to the VAS, pain intensity is graded as "no pain" 0 points and "worst unbearable pain" 10 points (10 cm scale).
Range of motion
Time Frame: 3 weeks
In the study, a digital goniometer, which has been validated and reliable, was used to objectively evaluate the normal range of motion of the shoulder. Normal range of motion of the shoulder will be evaluated by measuring the range of motion of shoulder flexion, extension, abduction, internal rotation and external rotation movements.
Joint position sense
Time Frame: 3 weeks
In this study, using this mobile application, the patient will perform 50-70-90 and 110 degrees of shoulder flexion with eyes open. Then, the patient will be asked to position the arm at the same angles with the eyes closed. Then the degrees of deviation will be calculated.
Secondary Outcomes
- The Short Form-36 Quality of Life Questionnaire(3 weeks)
- Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH):(3 weeks)
- TAMPA Kinesiophobia Scale(3 weeks)
Investigators
Burçin Akçay
Associate Professor
Bandırma Onyedi Eylül University