Effects of a Scapular-focused Exercise Protocol for Patients With Rotator Cuff Related Pain Syndrome - a Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- DASH disabilities of the arm, shoulder and hand
研究概览
简要总结
Background: Current clinical practice still lacks consistent evidence in the physiotherapy management of Rotator cuff related pain syndrome (RCS). The purpose of this trial was to compare the effectiveness of a scapular-focused treatment with and without real-time electromyographic biofeedback (EMGBF) to a control therapy in patients with RCS.
Methods: 60 patients with RCS were divided into three groups: scapular-focused exercise protocol group (P_G n=20), scapular-focused exercise protocol with EMGBF group (P+EMGBF_G n=20) and control therapy group (CT_G n=20). Values of pain and function [Shoulder Pain and Disability Index (SPADI) questionnaire, complemented by the Numeric Pain Rating Scale (NPRS) and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire], scapular stabilizer neuromuscular control (SSNC), scapular stabilizer activation onset (SSAO), dynamic scapular alignment, range of motion (ROM) and glenohumeral flexor and abductor muscle strength (GMS) were assessed at baseline and after 6-weeks and compared within and between groups.
详细描述
In order to advance the understanding of the value of scapular-focused exercise for rotator cuff related syndrome, a new trial was designed with the main objective of comparing pain and function outcomes between three different treatment protocols for patients with RCS:
P_G - Scapular-focused exercise protocol without electromyographic biofeedback (EMGBF) P+EMGBF_G - Scapular-focused exercise protocol supported by real-time EMGBF CT_G - Control therapy group with manual therapy (glenohumeral joint physiologic and accessory mobilization) , massage to reduce upper trapezius (UT) stiffness, and shoulder rotation strengthening into external rotation Every outcomes was assessed at the beginning of treatment, and then, weekly until completed 6 weeks of treatment.
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
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •1- age between 18 and 60 years; 2 - primary complaint of shoulder pain 3 - RCS clinical diagnosis
排除标准
- •neurological symptoms;
- •positive thoracic outlet syndrome (screened with Allen's and Adson's tests);
- •history of shoulder surgery or fracture;
- •structural injuries confirmed by imaging (e.g. ligaments and labrum);
- •symptoms reproduced by cervical examination;
- •unable to commit to scheduled treatments;
- •Anti-inflammatory drug use
研究组 & 干预措施
Scapular-focused exercise protocol supported by real-time EMGBF
The scapular-focused exercise protocol followed the protocol described by dos Santos et al. (2021). The protocol uses sequential stages of motor relearning (cognitive, associative, and autonomous) as a framework, while promoting the integration of local and global muscle function in weekly sessions divided into three phases. The main purpose of the protocol is to increase scapular neuromuscular activity and control.
干预措施: Control Therapy (Other)
Scapular-focused exercise protocol supported by real-time EMGBF
The scapular-focused exercise protocol followed the protocol described by dos Santos et al. (2021). The protocol uses sequential stages of motor relearning (cognitive, associative, and autonomous) as a framework, while promoting the integration of local and global muscle function in weekly sessions divided into three phases. The main purpose of the protocol is to increase scapular neuromuscular activity and control.
干预措施: Scapular-focused exercise protocol without EMGBF (Other)
Scapular-focused exercise protocol without EMGBF
The same protocol described above was applied without EMGBF
干预措施: Scapular-focused exercise protocol with EMGBF (Other)
Scapular-focused exercise protocol without EMGBF
The same protocol described above was applied without EMGBF
干预措施: Control Therapy (Other)
Control therapy group
The control therapy group underwent conservative physical therapy, which included both manual and exercise therapy
干预措施: Scapular-focused exercise protocol with EMGBF (Other)
Control therapy group
The control therapy group underwent conservative physical therapy, which included both manual and exercise therapy
干预措施: Scapular-focused exercise protocol without EMGBF (Other)
结局指标
主要结局
DASH disabilities of the arm, shoulder and hand
时间窗: At 6 weeks after the treatment protocol (final assessment)
From zero (better score) to 100 (worst score)
NPRS numeric pain rating scale
时间窗: At 6 weeks after the treatment protocol (final assessment)
From zero (better score) to 10 (worst score)
SPADI shoulder pain and disability index
时间窗: At 6 weeks after the treatment protocol (final assessment)
From zero (better score) to 100 (worst score)
NPRS numeric pain rating scale
时间窗: At the initial assessment
From zero (better score) to 10 (worst score)
SPADI shoulder pain and disability index
时间窗: At the initial assessment
From zero (better score) to 100 (worst score)
DASH disabilities of the arm, shoulder and hand
时间窗: At the initial assessment
From zero (better score) to 100 (worst score)
次要结局
- dynamic scapular alignment(At 6 weeks after the treatment protocol (final assessment))
- range of motion(At 6 weeks after the treatment protocol (final assessment))
- scapular stabilizer activation onset(At 6 weeks after the treatment protocol (final assessment))
- scapular stabilizer neuromuscular control(At 6 weeks after the treatment protocol (final assessment))
- glenohumeral flexor and abductor muscle strength(At 6 weeks after the treatment protocol (final assessment))
- scapular stabilizer neuromuscular control(At the initial assessment)
- scapular stabilizer activation onset(At the initial assessment)
- dynamic scapular alignment(At the initial assessment)
- range of motion(At the initial assessment)
- glenohumeral flexor and abductor muscle strength(At the initial assessment)
研究者
Ricardo Matias
PhD
NOVA School of Science and Technology ı FCT NOVA