Shoulder Eccentric External Rotator Training for Subacromial Pain Syndrome

Shoulder External Rotator Eccentric Training for Subacromial Impingement Syndrome

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT02153827

Enrollment

Registered

2014-06-03

Start date

2014-03-31

Completion date

2016-01-31

Last updated

2016-10-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Subacromial Impingement Syndrome

Keywords

Shoulder, Eccentric Training, Subacromial Impingement Syndrome

Brief summary

The purpose of this study is to examine the effects of eccentric exercise to the shoulder muscles for people with shoulder pain. Identifying specific exercise protocols for individuals with shoulder pain will provide evidence to help clinicians select the best interventions.

Detailed description

Prior investigations for eccentric training of the shoulder have primarily utilized a pain provocation model for exercise progression. This method of progressing resistance training load and volume assumes that pain must be increased during the exercise movement for clinical benefit to occur. When the individual reports a reduction in pain, load is increased so that the provoking pain level returns. The contrast to this approach would be a performance based progression as utilized in the Blume et al study for shoulder eccentric training. This method progresses a patient based on ability to perform a higher number of repetitions at a given load without increasing symptoms which could be favorable in many clinical settings. Further investigation on the role of eccentric training, specifically to the shoulder external rotators, in patients with SAPS is warranted. Thus, the aim of this investigation was to compare outcomes, for individuals diagnosed with SAPS, performing a six week protocol of eccentric training to the shoulder external rotators compared to a general exercise protocol.

Interventions

OTHEREccentric Shoulder External Rotator Training

Eccentric training exercise for the external rotators, 3 sets of 15 daily.

OTHERGeneral Shoulder exercise

general exercise consisting of active shoulder movements

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Presence of non-acute shoulder pain (greater than 3 months duration) * 3 out of the 6 following tests positive, Neer impingement, Hawkins-Kennedy impingement, empty can test, resisted external rotation test, palpable tenderness at the insertion of the supraspinatus or infraspinatus, and painful arc from 60° to 120° during active abduction. * Age over 18 years old * Sufficient ability to read English as required for completing questionnaires

Exclusion criteria

* Red flags noted in the patient's Medical Screening Questionnaire (MSQ) (ie. tumor, fracture, metabolic diseases, rheumatoid arthritis, osteoporosis, prolonged history of steroid use) * Full thickness supraspinatus or infraspinatus tendon tear as determined by a positive drop arm test, lag sign or rent test. * Shoulder adhesive capsulitis as evidenced by a limitation in passive motion for all shoulder planes of movement. * Having an upper extremity amputation. * Individuals having a history of surgery to the cervical spine or involved upper extremity for a musculoskeletal, neurological or dermatological condition for which they are at the time of data collection receiving post-operative care. * Pending legal action regarding their shoulder pain * Inability to comply with treatment and follow up schedule * Insufficient English language skills to complete all questionnaires

Design outcomes

Primary

Measure	Time frame	Description
Change in Western Ontario Rotator Cuff Index	6 months	shoulder functional self report measure is a disease specific self reported outcome measure for individuals experiencing rotator cuff pathology. A score of 0 is the minimum score and indicates low levels of shoulder function. A score of 100 is the maximum score and indicates full shoulder function. Scores are derived by summing all 5 subscales and dividing that number by the total available number of 2100. Units for each item are derived from a visual analog scale totaling 100cm.

Secondary

Measure	Time frame	Description
Global Rating of Change	6 months	Global rating of change is a single item questionnaire asking about total change since beginning treatment. The scale ranges from -7 (a great deal worse) to +7 (a great deal better). The unit of measure is scores on a scale.
Numeric Pain Rating Scale	6 months	0-10 pain scale with 0 meaning no pain and 10 being maximal pain. This is derived from a single item questionnaire.
Shoulder Active Range of Motion	6 months	Degrees of shoulder elevation with 0 being the least and 180 being the greatest.
Upper Quarter Y Balance Test	6 months	Measure of single arm reach with 0 being the least and higher numbers indicating greater distance reached.

Countries

United States

Participant flow

Recruitment details

March 2014 - October 2015 participants were recruited from the local community via publicly displayed flyers.

Pre-assignment details

none to report

Participants by arm

Arm	Count
Eccentric External Rotator Training Eccentric Shoulder External Rotator Training Eccentric Shoulder External Rotator Training	25
General Shoulder Exercise General Shoulder exercise: general exercise consisting of active shoulder movements	23
Total	48

Withdrawals & dropouts

Period	Reason	FG000	FG001
Overall Study	Lost to Follow-up	3	9

Baseline characteristics

Characteristic	Eccentric External Rotator Training	General Shoulder Exercise	Total
Age, Continuous	43.35 years STANDARD_DEVIATION 17.88	48.35 years STANDARD_DEVIATION 16.89	45.85 years STANDARD_DEVIATION 17.38
Body mass	79.87 Kilograms STANDARD_DEVIATION 15.04	81.90 Kilograms STANDARD_DEVIATION 18.55	80.88 Kilograms STANDARD_DEVIATION 16.795
Sex: Female, Male Female	10 Participants	10 Participants	20 Participants
Sex: Female, Male Male	15 Participants	13 Participants	28 Participants

Adverse events

Event type	EG000 affected / at risk	EG001 affected / at risk
deaths Total, all-cause mortality	— / —	— / —
other Total, other adverse events	0 / 25	0 / 23
serious Total, serious adverse events	0 / 25	0 / 23

Arm	Measure	Value (MEAN)	Dispersion
Eccentric External Rotator Training	Upper Quarter Y Balance Test	1.21 cm of reach divided by limb length	Standard Deviation 13
General Shoulder Exercise	Upper Quarter Y Balance Test	1.12 cm of reach divided by limb length	Standard Deviation 0.29

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026