Shoulder Impingement Syndrome Clinical Trial
Official title:
Comparison of an Eccentric Exercise Intervention to a Concentric Exercise Intervention in Adults With Subacromial Impingement Syndrome
The purpose of this study is to compare two different physical therapy exercise programs in
persons who have shoulder pain in order to determine if they have a different affect on pain
level and ability to use the injured shoulder after treatment. Both exercise groups will
attend physical therapy for an hour,two to three times a week, for eight weeks. The first
two weeks of therapy sessions will involve learning the exercises and testing to determine
what weight to use during exercises. One group will perform a traditional therapy exercise
program for shoulders using hand weights. The other group will perform a version of the same
shoulder exercises but with a different exercise technique. Exercises in both programs are
part of the standard of care for shoulder impingement in physical therapy but one program
concentrates on the lowering portion of the exercise (eccentrics) while the other emphasizes
the lifting portion of the exercise (concentrics). Both groups will perform the same
warm-up, stretching, and cool-down exercises. Participants will also be required to perform
a daily home exercise program of stretches and range of motion that will take about 20
minutes to complete. Exercise testing will determine the hand weight resistance used by each
person during their therapy sessions and re-testing will occur every two weeks to determine
any changes in the weight used for the exercises to keep them challenging. Pain level,
ability to use the injured arm for daily activities, strength, and amount of movement in the
shoulder, will be measured at the start of physical therapy and after five and eight weeks
(end of study) of the exercise treatments. A concurrent study investigating the reliability
of the shoulder motion and strength measurements used in the larger study will also be
performed.
Research hypotheses:
1. Adults with shoulder pain who complete the eccentric progressive resistive exercise
intervention will demonstrate significantly greater improvements in the outcome
measures at three weeks, earlier in the intervention, than the concentric progressive
resistive exercise intervention group.
2. Adults with shoulder pain who perform progressive resistive exercise interventions,
regardless of contraction type, will demonstrate significant improvement in the
shoulder outcome measures at three and six weeks of intervention.
This study will be a prospective, repeated-measure, randomized clinical trial comparing shoulder outcome measures in adults with SAIS following eccentric or concentric progressive resistance exercise intervention programs. Subjects: 36 persons with SAIS, aged 18 and older, will be recruited from the Texas Health Resources Dallas outpatient rehabilitation department and referring physicians. Procedures: Participants will be randomly assigned to either a concentric or eccentric intervention group. Participants will complete outcome measures for pain intensity, shoulder function, shoulder pain-free active range of motion (AROM) of flexion and scapular plane elevation, and shoulder pain-free strength of external rotation and abduction. Outcomes will be assessed by an investigator blinded to group assignment at baseline and after three and six weeks of intervention. Interventions will consist of supervised exercise sessions three times a week. Exercise progression will follow a standardized and systematic approach. The reliability of the AROM and strength outcome measures will be assessed concurrently using a random subset of six participants from each group. ;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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