Rotator Cuff Syndrome of Shoulder and Allied Disorders
Conditions
Keywords
scapula neuromuscular activity and control, rotator cuff related pain syndrome, scapular dyskinesis, electromyographic biofeedback, control therapy, pain and function
Brief summary
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.
Detailed description
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.
Interventions
OTHERScapular-focused exercise protocol with EMGBF
Scapular-focused exercises, based on the dos Santos et al (2021) protocol with the aid of the electromyographic biofeedback
OTHERControl Therapy
manual and exercise therapy
OTHERScapular-focused exercise protocol without EMGBF
Scapular-focused exercises, based on the dos Santos et al (2021) protocol
Sponsors
NOVA School of Science and Technology ı FCT NOVA
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1- age between 18 and 60 years; 2 - primary complaint of shoulder pain 3 - RCS clinical diagnosis
Exclusion criteria
1. \- neurological symptoms; 2. \- positive thoracic outlet syndrome (screened with Allen's and Adson's tests); 3. \- history of shoulder surgery or fracture; 4. \- structural injuries confirmed by imaging (e.g. ligaments and labrum); 5. \- symptoms reproduced by cervical examination; 6. \- unable to commit to scheduled treatments; 7. \- Anti-inflammatory drug use
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| NPRS numeric pain rating scale | At the initial assessment | From zero (better score) to 10 (worst score) |
| SPADI shoulder pain and disability index | At the initial assessment | From zero (better score) to 100 (worst score) |
| DASH disabilities of the arm, shoulder and hand | At the initial assessment | From zero (better score) to 100 (worst score) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| range of motion | At the initial assessment | Goniometry |
| scapular stabilizer neuromuscular control | At the initial assessment | Electromyographic Biofeedback (EMGBF) PhysiopluxTM system version 1.06 |
| glenohumeral flexor and abductor muscle strength | At the initial assessment | Manual Testing From 0 (worst) to 5 (normal) |
| scapular stabilizer activation onset | At the initial assessment | Electromyographic Biofeedback (EMGBF) PhysiopluxTM system version 1.06 |
| dynamic scapular alignment | At the initial assessment | Observation of the medial and the inferior prominences of the scapula |
Countries
Portugal
Outcome results
None listed