None listed
Conditions
Brief summary
Background: Subacromial impingement syndrome (SIS) was one of the most common causes of shoulder pain. Theoretically, exercise focus on motor control training combined with myofascial trigger points (MTrP) therapy can result in positive treatment outcome. However, there were still patients did not respond more to this kind of treatment than general therapeutic exercise for their SIS. Purposes: (1) To investigate the predictors for the effects from motor control training combined with MTrP therapy in patients with SIS. (2) To specifically determine the influencing factors of the magnitude of changes in function and pain after receiving motor control training combined with MTrP therapy. Research design: A prospective cohort study design. Methods: We plan to recruit 120 patients of SIS treated with motor control training combined with MTrP therapy for 8 weeks. Their socio-demographic data, occupational factors, characteristics of shoulder complaints, shoulder aberrant movements and fear avoidance belief were recorded. Outcome assessments were performed after intervention. The treatment responders were determined by fulfilling two of the two criteria: (1) increase of function (Patient Specific Functional Scale) > 1.2, (2) decrease of pain (Numeric Pain Rating Scale) > 2.17. Statistical analyses: For study purpose 1: univariate analyses comparing differences between responders and non-responders will be used to identify possible predictors (p<0.15). Then, a multivariate stepwise logistic regression analysis will be used to identify significant predictors for the treatment effect (p<0.05). For study purpose 2: the correlation analyses will be performed to find the possible affecting factor of the changing of the pain and function (p<0.15), then multivariate analysis will be used to identify those factors associated with the improvement of pain and function (p<0.05).
Interventions
1. Motor control training combined with MTrP therapy include (1) manual compression on MTrPs of shoulder muscles (levator scapulae, pectoralis minor, infraspinatus, teres minor, trapezius, rhomboids), each point for 30-60 sec, 2-3 repetitions. MTrP treatment was administered by each patient's physical therapist. (2) Immediately after the MTrp treatment, shoulder range of motion exercise with stretching to achieve maximum painfree shoulder flexion, abduction, internal and external rotation was pe
1. Motor control training combined with MTrP therapy include (1) manual compression on MTrPs of shoulder muscles (levator scapulae, pectoralis minor, infraspinatus, teres minor, trapezius, rhomboids), each point for 30-60 sec, 2-3 repetitions. MTrP treatment was administered by each patient's physical therapist. (2) Immediately after the MTrp treatment, shoulder range of motion exercise with stretching to achieve maximum painfree shoulder flexion, abduction, internal and external rotation was performed. (3) Shoulder motor control retraining: Patients were instructed to maintain a scapular neutral position and consequently taught to find the neutral position themselves. Patients were shown and told to avoid several incorrect muscle activation strategies. The patient was asked to control the orientation of the scapula whilst performing arm flexion to 90° in the sagittal plane, arm abduction to 60° in the scapular plane and arm medial rotation to 60°. Movements were performed 3 sets of 10 repetitions for each direction. Once scapular control had improved, external resistance exercises with a light weight or a thera-band were added to the program. Same exercise intensity (3 sets of 10 repetitions for each direction) was used. The duration of the exercise and MTrP therapy within each session was about 1 hour. 2. The socio-demographic data, occupational factors, characteristics of shoulder complaints, shoulder aberrant movements, pressure pain threshold, and shoulder range of motion will be evaluated as potential prognostic factors. All patients will receive motor control exercises combined with MTrP therapy twice a week for 8 weeks or until patients achieve their goals.
Sponsors
Shin Kong Memorial Wu Ho-Su Hospital
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
20 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
unilateral shoulder impingement syndrome Subjects had to demonstrate at least 3 of the following: (1) Neer impingement test: + (2) Hawkins impingement test: + (3) Painful arc (4) Pain with isometric resisted abduction (5) Pain with palpation of the rotator cuff tendons (6) Pain with active shoulder elevation
Exclusion criteria
Bilateral shoulder pain Affected shoulder dislocation, fracture, adhesive capsulitis, previous surgery Full-thickness rotator cuff tear Reproduction of shoulder symptoms with cervical spine examination History of any systemic or neurologic disease affecting the shoulder
Outcome results
None listed