The Effect of Isolytic and Static Stretching Training in Individuals With Subacromial Impingement Syndrome

Subacromial Impingement Syndrome Clinical Trial

Official title:

The Effect of Isolytic and Static Stretching Training in Individuals Having Subacromial Impingement Syndrome With Glenohumeral Internal Rotation Deficit

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03246698
• Other study ID #: 3413-GOA
• Status: Completed
• Phase: N/A
• Start date: August 28, 2017
• Est. completion date: July 20, 2019

Study information

• Verified date: July 2022
• Source: Dokuz Eylul University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to investigate and compare the effect of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit. Isolytic group will receive isolytic stretching in modified cross body stretching position and standard physiotherapy program. Static group will receive static stretching in modified cross body stretching position and standard physiotherapy program. Control group will receive only standard physiotherapy program.

Description:

The effectiveness of static stretching on various parameters such as range of motion or pain is studied and proved in literature. Static stretching in cross body position was also found helpful for improving shoulder range of motion with some disadvantages. In modified cross body position, the patient is positioned in a more advantageous way for him/her. Usually this stretching is done as active-assistive static stretching with the physiotherapist. Proof is still needed for the effectiveness of active-assistive static stretching in modified cross body position. Furthermore, there is no research about the effect of isolytic stretching which is relatively new technique compare to static stretches in subacromial impingement syndrome. In isolytic stretching, when the patient contracts the agonist muscle group with 20% muscle force active-assistive streching in agonist muscle group by the physiotherapist at the same time is done for 2-4 seconds. A fast isolytic stretching is applied in order to break the fibrous tissue. Our purpose is to investigate and compare the effect of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit . Stretching groups will receive either isolytic or static stretching in modified cross body stretching position and standard physiotherapy program. There is a control group. Control group will receive only standard physiotherapy program. Standard physiotherapy program includes TENS, hotpack, posture and strengthening training program. Treatment program will last four times a week (4-4-4-3) for four weeks, 15 sessions in total.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 70
• Est. completion date: July 20, 2019
• Est. primary completion date: June 20, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Diagnosis of subacromial impingement syndrome
• Glenohumeral internal rotation range of motion of the affected shoulder should be less than other shoulder and bilateral shoulder internal rotation range of motion difference should be =15 º
• Pain with resisted arm elevation or external rotation as well as a minimum of 3 of 5 positive subacromial impingement syndrome tests, painful arc, pain or weakness with resisted external rotation, Neer, Hawkins and Jobe tests.
• Ability to complete the entire study procedure

Exclusion Criteria:

• A 50% limitation of passive shoulder range of motion in >2 planes of motion
• Pain >7/10
• A history of fracture to the shoulder girdle
• Systemic musculoskeletal disease
• History of shoulder and cervical surgery
• Glenohumeral instability (positive apprehension, relocation, or positive sulcus test) or positive findings for a full-thickness rotator cuff tear (positive lag sign, positive drop arm test, or marked weakness with shoulder external rotation)
• Neck and shoulder pain with active/passive cervical spine movement
• A diagnosis of chest deformity or scoliosis
• Regularly performing posterior shoulder stretching exercises

Related Conditions & MeSH terms

• Rotator Cuff Injuries
• Shoulder Impingement Syndrome
• Subacromial Impingement Syndrome
• Syndrome

Intervention

Other:
• Isolytic Stretching group
In modified cross body position, isolytic stretching exercises will perform five times each for 15 seconds. After each stretching patient will rest for 5 seconds. When the patient contracts the agonist muscle group with 20% muscle force, the agonist muscle group is stretched at the same time for 2-4 seconds. Isolytic stretching exercises will perform four times a week for four weeks. It's obligatory to receive at least 15 sessions in total. They will also receive standard physiotherapy program four times a week for four week, 15 sessions in total.
• Static Stretching group
In modified cross body position, active-assistive static stretching exercises will be performed 5 times each for 15 seconds. This stretching exercise is performed 5 times with 5 seconds intervals. Static stretching exercises will perform four times a week for four weeks. It's obligatory to receive at least 15 sessions in total. They will also receive standard physiotherapy program four times a week for four week, 15 sessions in total.
• Control group
They will receive only standard physiotherapy program, four times a week for four weeks, 15 sessions in total.

Locations

Country	Name	City	State
Turkey	Dokuz Eylül University	Izmir	Balçova

Sponsors (1)

Lead Sponsor	Collaborator
Dokuz Eylul University

Country where clinical trial is conducted

Turkey, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Shoulder internal rotation range of motion	Change of shoulder internal rotation range of motion (with bubble inclinometer)	Baseline and 4 weeks
Secondary	Glenohumeral internal rotation deficit	Change of difference in shoulder internal rotation range of motion between the affected and non-affected shoulder (with bubble inclinometer)	Baseline and 4 weeks
Secondary	Posterior shoulder tightness	Change of posterior shoulder tightness (with bubble inclinometer)	Baseline and 4 weeks
Secondary	Shoulder external rotation range of motion	Change of shoulder external rotation range of motion (with bubble inclinometer)	Baseline and 4 weeks
Secondary	Shoulder total rotational range of motion	Change of shoulder total rotational range of motion (Sum of the internal and external rotation motion)	Baseline and 4 weeks
Secondary	Resting and activitiy pain in shoulder	Change of visual analog scale score in activity and rest pain	Baseline and 4 weeks
Secondary	Subacromial space	Change of subacromial space at arm resting at the side (0°), and at 60° of scapular plane elevation (with Ultrasound)	Baseline and 4 weeks
Secondary	Supraspinatus tendon thickness	Change of supraspinatus tendon thickness (with Ultrasound)	Baseline and 4 weeks
Secondary	Concentric strength	Change of rotattor cuff muscles concentric strength (in kg, with hand held dynamometer)	Baseline and 4 weeks
Secondary	Eccentric strength	Change of shoulder abduction eccentric strength (in kg, with hand held dynamometer)	Baseline and 4 weeks
Secondary	Shoulder Function	Change of Modified Constant-Murley Score	Baseline and 4 weeks
Secondary	Upper extremity function	Change of disabilities of the arm, shoulder, and hand (Quick-DASH) score	Baseline and 4 weeks