Neurophysiology of Weakness and Exercise in Rotator Cuff Tendinopathy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 180
- 试验地点
- 2
- 主要终点
- Rotator cuff activation after subacromial injection and exercise intervention, difference in specific rotator cuff muscle activation between subjects and controls
研究概览
简要总结
The purpose of this study is to examine deficits in activation and motor patterns, as well as central drive in patients with rotator cuff tendinopathy. There are three specific aims: (1) determine the effect of acute pain relief on rotator cuff muscle activation in patients with rotator cuff tendinopathy, (2) determine the effect of exercise on rotator cuff muscle activation in patients with rotator cuff tendinopathy, and (3) compare rotator cuff muscle activation between patients with rotator cuff tendinopathy and healthy controls.
详细描述
The long-term goal of our research agenda is to identify the mechanisms associated with rotator cuff tendinopathy (impingement syndrome) and subsequently evaluate novel treatment strategies that address these mechanisms. The objectives of this application are to study the muscle patterns in patients with rotator cuff tendinopathy as well as the effects of both pain and exercise on these patterns. Our first hypothesis is that pain relief from a shoulder injection will result in increased rotator cuff activity. Our second hypothesis is that patients with tendinopathy will demonstrate improved rotator cuff muscle activity following a six-week exercise program and that this improvement will be higher in patients that respond favorably to treatment. Our final hypothesis is that patients with cuff tendinopathy will show decreased rotator cuff activity compared to healthy subjects. The investigators plan on addressing these hypotheses using several novel techniques for muscle activity assessment.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 21 Years 至 45 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •pain with passive provocative maneuvers (positive Hawkins or Neer test)
- •pain with active elevation (positive painful arc)
- •pain with isometric resisted movements (Jobe's "empty can" test or resisted shoulder external rotation with the arm at the side)
- •demonstrate weakness (>10% force deficit in external rotation)
排除标准
- •shoulder surgery on the symptomatic side
- •positive Spurling test
- •traumatic shoulder dislocation or instability in the past 3 months
- •reproduction of shoulder pain with active or passive cervical range of motion
- •signs of rotator cuff tear (drop-arm test, lag signs, gross external rotation weakness, or positive image findings)
- •current musculoskeletal, neurologic or cardiovascular compromise
- •Control Inclusion Criteria:
- •no current or previous shoulder injury
- •matched for age (within 5 years) and sex
- •meet Patient Exclusion Criteria (minus musculoskeletal, neurologic, or cardiovascular compromise)
- •Control Exclusion Criteria:
- •pain with active arm elevation
- •positive Hawkins, Neer, or Jobe's test
结局指标
主要结局
Rotator cuff activation after subacromial injection and exercise intervention, difference in specific rotator cuff muscle activation between subjects and controls
时间窗: 6 weeks
Assessed using electromyography (EMG)
Rotator cuff activation after subacromial injection and exercise intervention, difference in rotator cuff voluntary activation between subjects and controls
时间窗: 6 weeks
Assessed using voluntary activation
次要结局
- Rotator cuff voluntary activation after subacromial injection(2 hours)
- Rotator cuff voluntary activation correlations with pain levels(2 hours)
- Rotator cuff muscle activation correlation with improvements in clinical outcome measures(6 weeks)
- After both a subacromial injection and a six-week exercise program, differences in rotator cuff voluntary activation between patients and healthy controls(6 weeks)
- After both a subacromial injection and a six-week exercise program, differences in rotator cuff muscle activation between patients and healthy controls(6 weeks)
- Rotator cuff muscle activation after subacromial injection(2 hours)
- Rotator cuff voluntary activation after 6-week exercise intervention and subacromial injection(6 weeks)
- Rotator cuff muscle activation after 6-week exercise intervention and subacromial injection(6 weeks)
- Prior to treatment, rotator cuff voluntary activation in patients relative to healthy controls(6 weeks)
- Rotator cuff activation correlations with pain levels(2 hours)
- Rotator cuff muscle activation correlation with improvements in pain relief(6 weeks)
- Rotator cuff voluntary activation correlation with improvements in pain relief(6 weeks)
- Rotator cuff voluntary activation correlation with improvements in clinical outcome measures(6 weeks)
- Prior to treatment, rotator cuff muscle activation in patients relative to healthy controls(6 weeks)