Tendinopathy Clinical Trial
Official title:
Effect of Adding Muscle Coactivation to Regular Shoulder Strengthening Exercises on Function and Pain With Patients Suffering of Rotator Cuff Tendinopathy: A Single-Blind Randomized Controlled Trial
Rotator cuff tendinopathy (RCT) is the most frequent cause of shoulder pain. RCT is
frequently termed as impingement syndrome, based on the underlying mechanism in which the
subacromial space soft tissues (subacromial bursa, rotator cuff tendons and long head of the
biceps tendon) get encroached under the coracoacromial arch when the arm is elevated. RCT
contributes in the decrease in quality of life and function, and in inducing work
incapacities and sleep disorders.
Exercises, as conservative management, were shown to be effective in increasing function and
in decreasing pain related to RCT. However, the lack of studies comparing different types of
exercises (i.e. concentric, eccentric, scapular strengthening, proprioceptive, coactivation)
is reported by many systematic reviews. One type of exercise, coactivation strengthening,
could be more efficient. Coactivation strengthening implies a recruitment of the pectoralis
major and the latissimus dorsi while performing regular strengthening. When theses muscles
are recruited, the medio-inferior orientation of their tendons creates a force vector that
limits the superior translation of the humeral head, thus limits the subacromial narrowing.
The aim of this study is to evaluate the efficacy of coactivation strengthening exercises in
patient with RCT compared to regular strengthening exercises. Forty-two participants
diagnosed with RCT by an orthopaedic surgeon following a standardized protocol will be
randomised to either coactivation or regular strengthening exercises. Participants will
perform a 6-week exercise protocols. Outcomes will be measured at baseline, and at three,
six, 12, 18 and 24 weeks. The primary outcome is function assessed with the Disabilities of
arm, shoulder and Hand (DASH) questionnaire. Secondary outcomes focus on pain (visual analog
scale), quality of life (Western Ontario Rotator Cuff Index), impression of change (Patient
Global Impression of Change), subacromial distance (ultrasonography) and muscular strength
(manual dynamometer). Investigators expect that coactivation strengthening exercises will be
more efficient over the short and long term.
This trial will provide data to guide clinicians in the treatment of RCT to reduce recovery
time and to bring patients back as quickly as possible to work or usual function.
n/a
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