The clinical effect of enhancing adductor co-contraction in Subacromial Pain Syndrome: a prospective single-centre randomised controlled trial

Recruitment & Eligibility

Status: Recruiting

Sex: Not specified

Target Recruitment: 80

Inclusion Criteria

Chronic shoulder pain (>3months).
- Suspicion of subacromial origin of pain (e.g. combination of positive painful arc test, Hawkins-Kennedy test and empty can test).
- Presence of conventional radiographs.

Exclusion Criteria

- Younger than 18 years of age;
- History of fracture or dislocation of the shoulder;
- History of surgery around the shoulder;
- Clinical and/or radiographic signs of comorbidities or alternative diagnoses of the affected shoulder (glenohumeral instability, glenohumeral/acromioclavicular osteoarthritis or arthritis, rheumatic disorder, history of trauma of the affected shoulder, capsulitis adhesiva, complete (full thickness) rotator cuff rupture, cervical radiculopathy,plexus lesions). - Tendinitis calcarea, although part of saps; requires different treatment methods.
- Neoplasms;
- Pregnancy;
- Cognitive impairment;
- Electronic implants (e.g. Implantable Cardioverter Defibrillator, pacemaker);
- Insufficient Dutch language skills;
- Refusing physical therapy treatment (for example, due to the absence of reimbursement);
- Received physical therapy treatment in past three months;
- Refusing subacromial corticosteroid injection;
- Received subacromial corticosteroid injection in last month;
- No informed consent.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Clinical outcomes are pain (Visual Analogue Scale), arm-shoulder function (Constant score), bio-physical-social health (RAND-36, Shoulder Rating Questionnaire) and, self-reported quality of life (Western Ontario Rotator Cuff index). Co-contraction as assessed with EMG will be expressed using the Activation Ratio ([AR]; range [-1 to1]), indicating the task-related amount of antagonist activation relative to the same muscle’s degree of agonistic activation, corresponding to 1 in case of pure agonist muscle activation and -1 in case of pure antagonistic activation.

Secondary Outcome Measures

Name	Time	Method
Movement complexity and proprioception, factors that potentially associate with the clinical course of SAPS will be assessed using electromagnetic motion analysis (Flock of Birds, FoB). Additionally, we will evaluate the content of care provided and compliance of the patients by asking the patients to fill out a registration form on the frequency, duration and content of treatment.

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