Comparison of Dynamic Ultrasound Visual Feedback to Manual Feedback on Scapular Stabilizer Activation and Change in the Subacromial Space in Persons With Pain During Shoulder Elevation
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 26
- 试验地点
- 1
- 主要终点
- Muscle activity during functional task
研究概览
简要总结
Purpose of the Study This study looks at whether using real-time ultrasound images as feedback can help people better activate two important shoulder muscles-the serratus anterior and lower trapezius-compared to standard verbal or visual feedback from a clinician. The study also examines whether this training carries over to everyday arm movements and whether it helps create more space inside the shoulder joint.
Why This Matters Shoulder pain is very common. One possible cause is poor movement or poor muscle control of the shoulder blade, which can reduce the space under the shoulder and lead to pain. The serratus anterior and lower trapezius muscles help the shoulder blade move correctly when lifting the arm. Improving how these muscles work may reduce pain and improve shoulder function.
How the Study Is Done
People with shoulder pain will take part in the study in a university laboratory. They will be randomly placed into one of two groups:
One group will receive muscle training with ultrasound images that show their muscles working in real time.
The other group will receive standard feedback without ultrasound.
Participants will perform specific shoulder exercises targeting the two muscles. Muscle activity will be measured before and after training using specialized sensors. The researchers will also see if the muscle training improves muscle use during a more functional movement, such as lifting the arm to shoulder height. In addition, ultrasound will be used to measure the space inside the shoulder joint before and after training.
Why This Is Important for Care If ultrasound feedback is shown to be effective, it could give physical therapists and other clinicians a new tool to help patients better activate key shoulder muscles. This may improve treatment options for people with shoulder pain, especially pain at the top of the shoulder.
详细描述
Introduction
Shoulder pain is very common and affects people all over the world. About 1 in 6 people experience shoulder pain at any given time, and many new cases occur each year. It is one of the top causes of muscle and joint pain, behind only a few other conditions. Shoulder pain can significantly affect daily activities and quality of life, with common diagnoses including rotator cuff problems and shoulder impingement.
Pain at the top of the shoulder often happens when people lift their arms overhead. For the shoulder to move properly, the shoulder blade must move in a coordinated way with the arm. When the arm lifts, the shoulder blade needs to rotate upward, tilt backward, and rotate slightly outward. These movements depend heavily on certain muscles, especially the serratus anterior and the upper and lower trapezius muscles.
Research has shown that people with shoulder pain often have poor muscle balance around the shoulder blade. In many cases, the upper trapezius muscle becomes overactive, while the lower trapezius and serratus anterior muscles are underactive. This imbalance can interfere with normal shoulder movement and may contribute to pain.
Another factor linked to shoulder pain is a decrease in the space inside the shoulder joint where tendons pass. When this space becomes smaller, structures in the shoulder can become pinched during arm movements, especially overhead. Proper movement of the shoulder blade helps lift part of the shoulder bone out of the way, preventing this pinching. Studies show that strengthening and retraining shoulder blade muscles can reduce pain and improve shoulder function. Other research has demonstrated that activating the serratus anterior and lower trapezius muscles can actually increase the space inside the shoulder joint, highlighting the importance of proper muscle control.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Subjects with apical shoulder pain
- •Pain level >2 on the numeric pain rating scale
- •Able to elevate shoulder beyond 140º
- •Able to perform all research activities without difficulty
排除标准
- •Experience shoulder pain > 6 on the numeric pain rating scale
- •Presence of a known neurological disorder
- •Shoulder pain only elicited with neck movements
- •History of shoulder fracture or surgery involving the glenohumeral joint capsule
- •Diagnosis of adhesive capsulitis
- •Previously received treatment for the scapular upward rotators
研究组 & 干预措施
Standardized exercise feedback
Exercise will be performed with tactile and verbal feedback only
干预措施: Verbal and tactile feedback with exercise (Other)
Standardized exercise feedback with dynamic ultrasound feedback
Standard feed back of verbal and tactile cueing with the addition of dynamic ultrasound imaging feedback
干预措施: Verbal and tactile feedback with exercise (Other)
结局指标
主要结局
Muscle activity during functional task
时间窗: Immediately after treatment administration (Day 1)
Intramuscular electromyography will be used to record muscle activity during a functional task
Subacromial space size
时间窗: Immediately after treatment administration (Day 1)
Ultrasound imaging will be used to measure the size of the subacromial space
次要结局
- Muscle activity during a muscle specific task(Immediately after treatment administration (Day 1))
研究者
George Beneck
Professor
California State University, Long Beach