Influence of Kinetic Chain Training on the Treatment Outcome of Overhead Athletes With Shoulder Impingement Syndrome
Overview
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University Ghent
- Enrollment
- 38
- Locations
- 1
- Primary Endpoint
- Changes in Shoulder Pain And Disability Index (SPADI) score
Overview
Brief Summary
A randomized controlled trial will be conducted to examine the effectiveness of a traditional home exercise program versus 2 kinetic chain home exercise programs on treatment outcome of overhead athletes with shoulder impingement syndrome. Primary outcome measures are reduction of pain and disability, and improvement in functionality and sports performance. Secondary outcome measures are strength, mobility, flexibility and functional performance.
Detailed Description
Participant are randomly assigned in 3 home exercise groups.
- The traditional program: consists of solely strengthening the rotator cuff muscles and scapular muscles (e.g. external rotation)
- Separate kinetic chain program: same exercises as the first group but they also receive an exercise program to separately train the core and lower body. (e.g. external rotation separately and squat separately)
- Integrated kinetic chain program: same exercises as the first group but all exercises are performed while simultaneously activating the kinetic chain. (e.g. external rotation while squatting).
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Investigator)
Eligibility Criteria
- Ages
- 18 Years to 60 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Symptoms of shoulder impingement on the dominant side for at least 3 months and at least 3 of the following tests are considered positive
- •Painful arc during elevation
- •Pain or lack of force production with isometric external rotation
- •Apprehension test
- •Relocation test
- •Performing overhead sports at least 3 hours/week
- •Shoulder pain interferes with sports activities
- •They have not had treatment for this shoulder pain
Exclusion Criteria
- •History of shoulder dislocation or subluxation
- •History of orthopedic surgery
- •No complaints of pain or dysfunction in the upper limb (except impingement related complaints in the dominant shoulder), lower limb or spine at the last 6 months
- •Currently taking nonsteroidal anti-inflammatory medication
- •Received a steroid injection in the past 12 months
- •Participating in another study
- •Known systemic diseases
- •Known structural diseases
Outcomes
Primary Outcomes
Changes in Shoulder Pain And Disability Index (SPADI) score
Time Frame: At baseline and within one week after the 6-weeks training program
Patients will fill in the SPADI questionnaire to evaluate shoulder pain and function. The SPADI is a valid, reliable and frequently used questionnaire for shoulder pain patients consisting of 13 items divided in 2 subscales: pain (5 items) and disability (8 items). Each item was scored on a 10-point numeric rating scale. Total and subscale scores were summed and transformed to a score out of 100 (%) were a higher score indicates a higher level of pain and/or disability
Subjective perception of shoulder improvement
Time Frame: 6-weeks training program
A Global Rating of Change (GROC) scale was used to quantify patient-perceived improvement of overall shoulder function after 6 weeks treatment as "improved", "unchanged" or "worse". In case they improved or got worse, the amount of change was reflected on a 5-point scale: very little change, little change, some change, a large change, a very large change. An "unchanged" condition scored 0, "improved" between 1 and 5, and "worse" between -1 and -5 points. amount of change was scored on a 5-point scale (very little change, little change, some change, a large change, a very large change)
Changes in Western Ontario Shoulder Stability index (WOSI) score
Time Frame: At baseline and within one week after the 6-weeks training program
The WOSI is a patient-evaluated disease-specific quality of life scoring questionnaire that has been developed for shoulder instability patients. This 21-item questionnaire consists of 4 subscales: physical symptoms (10 items), sport/recreation/work (4 items), lifestyle (4 items), and emotions (3 items). Each item was scored on a 100-mm visual analogue scale. Total and subscale scores were summed and transformed to a score out of 100 (%) where a higher score indicates more limitations in shoulder related quality of life
Secondary Outcomes
- Changes in shoulder muscle isokinetic strength (Biodex system 4)(at baseline and within one week after the 6-weeks training program)
- Changes in shoulder scapular isokinetic strength(at baseline and within one week after the 6-weeks training program)
- Return To Play (RTP)(up to one week after the 6-weeks training program)
- Changes in scapular dyskinesis(at baseline and within one week after the 6-weeks training program)
- Changes in functional tests for the upper limb measured with the Seated Medicine Ball Throw(at baseline and within one week after the 6-weeks training program)
- Changes in functional tests for the upper limb measured with the Y Balance Test(at baseline and within one week after the 6-weeks training program)