Diaphragm; Relaxation, Rotator Cuff Injury
Conditions
Keywords
rotator cuff injury, diaphragm, physical therapy, manual therapy
Brief summary
A randomised and controlled trial to people diagnosed with rotator cuff injuries who are divided into 3 groups of treatment: shoulder myofascial trigger points release, manual diaphragm release and diaphragm mobilization through hipopressive gymnastic exercise. The pain and range of shoulder movement are assessed before and after the treatment in all the participants. Hypothesis of the clinical study: the treatment of diaphragm muscle, via manual release or active mobilization, has impact on rotator cuff injury symptoms comparing with a standard treatment of shoulder myofascial trigger points release. Discussion: The relation between shoulder and diaphragm muscle, through innervation (phrenic nerve and brachial plexus), embryology and myofascial connections, could lead to include in clinical practice the examination and treatment of other structures besides shoulder girdle such as diaphragmatic region in rotator cuff injuries.
Detailed description
This study is a randomised controlled trial evaluating clinical effects of a diaphragm treatment, via manual release or active mobilization, comparing with a standard treatment of shoulder myofascial trigger points release. A description of the 3 groups of treatment: 1. \- Experimental group 1: 3 diaphragm stretching techniques according to Chaitow, Ward and Ricard, performed by a physical therapist are employed in this experimental group during 10 minutes. The participants are situated in a seated, supine and side bending position. 2. \- Experimental group 2: diaphragm mobilization through active hipopressive gymnastic exercise according to Caufriez in two different postures. 3. \- Active comparator group: A ischemic compression technique in most painful myofascial trigger points in the infraespinatus and supraespinatus muscle during one minute each one. The shoulder flexion, abduction and external rotation range of motion will be assessed pre and postinterventions, as well as the pressure pain threshold with an algometer and the pain experienced by the individual in shoulder mobility with a Numerical Rating Scale.
Interventions
OTHERDiaphragm manual therapy techniques
3 diaphragm manual therapy techniques performed by a physical therapist are employed in this experimental group during 10 minutes. The participants are situated in a seated, supine and side bending position.
OTHERDiaphragm mobilization through active hipopressive gymnastic exercise
Diaphragm mobilization through active hipopressive gymnastic exercise in two different postures: standing and standing bending forward.
OTHERIschemic compression techniques in shoulder myofascial trigger points
Ischemic compression techniques in infraespinatus and supraespinatus myofascial trigger points during one minute each muscle. The pressure increases gradually until the individual feels a tolerable pain.
Sponsors
Universidad Complutense de Madrid
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Participants of both genders aged between 18 and 65 years old * Ultrasound and/or magnetic resonance imaging diagnosis of rotator cuff injury * Pain or range of movement restriction in active shoulder flexion and/or abduction
Exclusion criteria
* Use of analgesic or anti-inflammatory drugs 72 hours prior to the study * Individuals with glenohumeral instability due to shoulder luxation or subluxation or Bankart labrum injury * Individuals who have received physical therapy treatment in last week * Individuals who underwent thoracic or shoulder surgery or people suffering from rheumatisms * Diabetic patients * People with a diagnosed neurological pathology * Individuals with a diagnosed mental health problem * Not being able to understand and sign the informed consent and information sheet
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline to post intervention shoulder range of motion with a digital inclinometer | Baseline and Immediately Post Intervention | Pre and post treatment assessment of flexion, abduction and external rotation at 90º abduction movements in supine, registered with a Baseline digital inclinometer |
| Change from baseline to post intervention pressure pain threshold in supraespinatus tendon and xiphoid process with a pressure algometer | Baseline and Immediately Post Intervention | Pre and post treatment Pressure pain threshold in supraespinatus tendon and xiphoid process registered with a pressure algometer in a supine position |
| Change from baseline to post intervention Numerical Rating Pain Scale in shoulder mobility | Baseline and Immediately Post Intervention | Pre and post treatment Numerical Rating Pain Scale in shoulder mobility: flexion, abduction and external rotation at 90º abduction standing |
Countries
Spain
Outcome results
None listed