Exercise based management for atraumatic instability of the shoulder in circus arts performers

Not Applicable

Completed

• Conditions: Atraumatic Shoulder Instability; Musculoskeletal - Other muscular and skeletal disorders

• Registration Number: ACTRN12620000335998
• Lead Sponsor: Swinburne University of Technology

Brief Summary

Shoulder injuries in circus performers are common. The aim of this study was to evaluate the effectiveness of the Watson Instability Program delivered via telehealth on patient reported outcome measures, scapula position, shoulder strength and handstand stability in student circus performers with atraumatic shoulder instability. Twenty-four student circus arts performers participated in the study. Significant improvements were found for patient reported outcome measures (Western Ontario Shoulder Index, Melbourne Instability Shoulder Score and Orebro Musculoskeletal Pain Questionnaire) at all follow up timepoints. The Tampa Scale for Kinesiophobia scores reached significance at 6-weeks and 3-months. Following rehabilitation, statistically significant increases in shoulder strength in all positions tested and increased scapula upward rotation measured at end of range abduction, and during loaded external rotation were found. Affected arm showed greater instability compared to unaffected arm with significant intervention effect on the affected arm showing greater consistent anterior-posterior movement pattern. This study was unable to determine if results of a telehealth intervention would be equivalent to results of a face to face intervention, as no comparator intervention was used in this study.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2020-03-10
• Study Completion: 2020-11-30
• Last Update Posted: 5 July 2021

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 24

Inclusion Criteria

Report of shoulder region discomfort, pain or apprehension/guarding with movement
Willing to participate in 12-week exercise program
Clinically diagnosed symptomatic atraumatic shoulder instability in one or more directions.
Amenable to correction (symptomatically improve a participant’s abduction or flexion range of motion by a minimum of 20°, or, significantly reduce a participant’s pain or guarding in any objective measure, or, improve a participant’s strength on an isometric test).

Exclusion Criteria

History of significant trauma defined as contact with an external object (such as a fall, impact with another body or surface) with lock out of the glenohumeral joint and conscious awareness by the patient of a sudden onset of pain.
History of glenohumeral dislocation that requires relocation
Prior surgical history of the affected shoulder(s)
Non-correctable volitional instability
Inability to complete 5 repetitions of a 5 second duration shoulder shrug with no weight
Non-compliance
Neurological motor deficit
Instability due to UMN or LMN lesion
Ehlers-Danlos syndrome/Marfan’s syndrome
Shoulder pain that is predominantly due to cervical dysfunction including:
- Cervical spine somatic referred pain
- Cervical spine radicular pain
- Cervical spine radiculopathy
- Thoracic outlet syndrome

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
The Western Ontario Shoulder Instability Index (WOSI)<br>- a self-administered tool, with 21 items over the four domains of physical symptoms, sport/recreation/work, lifestyle function and emotional function.[Baseline, 6-weeks, 12-weeks [primary timepoint], 6 months and 9-months post baseline measures];The Melbourne Instability Shoulder Scale (MISS)<br>- a self-administered tool, with a total of 100 points, divided into four categories that assess pain, instability, function, and occupational and sporting demands.[Baseline, 6-weeks, 12-weeks [primary timepoint], 6 months and 9-months post baseline measures]