The Effect of Isolytic and Static Stretching Training in Individuals With Subacromial Impingement Syndrome
- Conditions
- Subacromial Impingement Syndrome
- Interventions
- Other: Control groupOther: Static Stretching groupOther: Isolytic Stretching group
- Registration Number
- NCT03246698
- Lead Sponsor
- Dokuz Eylul University
- Brief Summary
The purpose of this study is to investigate and compare the effect of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit. Isolytic group will receive isolytic stretching in modified cross body stretching position and standard physiotherapy program. Static group will receive static stretching in modified cross body stretching position and standard physiotherapy program. Control group will receive only standard physiotherapy program.
- Detailed Description
The effectiveness of static stretching on various parameters such as range of motion or pain is studied and proved in literature. Static stretching in cross body position was also found helpful for improving shoulder range of motion with some disadvantages. In modified cross body position, the patient is positioned in a more advantageous way for him/her. Usually this stretching is done as active-assistive static stretching with the physiotherapist. Proof is still needed for the effectiveness of active-assistive static stretching in modified cross body position. Furthermore, there is no research about the effect of isolytic stretching which is relatively new technique compare to static stretches in subacromial impingement syndrome. In isolytic stretching, when the patient contracts the agonist muscle group with 20% muscle force active-assistive streching in agonist muscle group by the physiotherapist at the same time is done for 2-4 seconds. A fast isolytic stretching is applied in order to break the fibrous tissue. Our purpose is to investigate and compare the effect of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit . Stretching groups will receive either isolytic or static stretching in modified cross body stretching position and standard physiotherapy program. There is a control group. Control group will receive only standard physiotherapy program. Standard physiotherapy program includes TENS, hotpack, posture and strengthening training program. Treatment program will last four times a week (4-4-4-3) for four weeks, 15 sessions in total.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 70
- Diagnosis of subacromial impingement syndrome
- Glenohumeral internal rotation range of motion of the affected shoulder should be less than other shoulder and bilateral shoulder internal rotation range of motion difference should be ≥15 º
- Pain with resisted arm elevation or external rotation as well as a minimum of 3 of 5 positive subacromial impingement syndrome tests, painful arc, pain or weakness with resisted external rotation, Neer, Hawkins and Jobe tests.
- Ability to complete the entire study procedure
- A 50% limitation of passive shoulder range of motion in >2 planes of motion
- Pain >7/10
- A history of fracture to the shoulder girdle
- Systemic musculoskeletal disease
- History of shoulder and cervical surgery
- Glenohumeral instability (positive apprehension, relocation, or positive sulcus test) or positive findings for a full-thickness rotator cuff tear (positive lag sign, positive drop arm test, or marked weakness with shoulder external rotation)
- Neck and shoulder pain with active/passive cervical spine movement
- A diagnosis of chest deformity or scoliosis
- Regularly performing posterior shoulder stretching exercises
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Control group Control group The participants in this group will receive only standard physiotherapy. Static stretching group Static Stretching group The participants in this group will receive static stretching in modified cross body position. Additionally they will receive standard physiotherapy. Isolytic stretching group Isolytic Stretching group The participants in this group will receive isolytic stretching in modified cross body position. Additionally they will receive standard physiotherapy.
- Primary Outcome Measures
Name Time Method Shoulder internal rotation range of motion Baseline and 4 weeks Change of shoulder internal rotation range of motion (with bubble inclinometer)
- Secondary Outcome Measures
Name Time Method Shoulder total rotational range of motion Baseline and 4 weeks Change of shoulder total rotational range of motion (Sum of the internal and external rotation motion)
Subacromial space Baseline and 4 weeks Change of subacromial space at arm resting at the side (0°), and at 60° of scapular plane elevation (with Ultrasound)
Glenohumeral internal rotation deficit Baseline and 4 weeks Change of difference in shoulder internal rotation range of motion between the affected and non-affected shoulder (with bubble inclinometer)
Posterior shoulder tightness Baseline and 4 weeks Change of posterior shoulder tightness (with bubble inclinometer)
Shoulder external rotation range of motion Baseline and 4 weeks Change of shoulder external rotation range of motion (with bubble inclinometer)
Supraspinatus tendon thickness Baseline and 4 weeks Change of supraspinatus tendon thickness (with Ultrasound)
Concentric strength Baseline and 4 weeks Change of rotattor cuff muscles concentric strength (in kg, with hand held dynamometer)
Eccentric strength Baseline and 4 weeks Change of shoulder abduction eccentric strength (in kg, with hand held dynamometer)
Resting and activitiy pain in shoulder Baseline and 4 weeks Change of visual analog scale score in activity and rest pain
Shoulder Function Baseline and 4 weeks Change of Modified Constant-Murley Score
Upper extremity function Baseline and 4 weeks Change of disabilities of the arm, shoulder, and hand (Quick-DASH) score
Trial Locations
- Locations (1)
Dokuz Eylül University
🇹🇷İzmir, Balçova, Turkey