Effects of a Movement Training for Subacromial Pain Syndrome

Shoulder Impingement Syndrome Clinical Trial

— MTforSPS  

Official title:

Effects of a Movement Training Oriented Rehabilitation Program on Symptoms, Functional Limitations and Acromiohumeral Distance in Individuals With Subacromial Pain Syndrome

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02395770
• Other study ID #: OPPQ-Apr2013
• Status: Completed
• Phase: N/A
• First received: March 9, 2015
• Last updated: March 17, 2015
• Start date: June 2013
• Est. completion date: September 2014

Study information

• Verified date: March 2015
• Source: Laval University
• Contact: n/a
• Is FDA regulated: No
• Health authority: Canada: Ethics Review Committee
• Study type: Interventional

Clinical Trial Summary

Objectives: Evaluate the effects of a rehabilitation program based on movement training on symptoms, functional limitations and acromiohumeral distance (AHD) in individuals with SPS.

Methods: Twenty-five participants with SPS participated in a 6-week program. Outcomes of both groups were evaluated at baseline and 6 weeks. Changes in symptoms and functional limitations were assessed. Changes in AHD for both groups were assessed using ultrasonographic measures.

Description:

Background: Multiple factors have been associated with the presence of a subacromial pain syndrome (SPS), including deficits in performance of scapular and glenohumeral muscles. Such deficits can lead to inadequate kinematics and decreased acromiohumeral distance (AHD). Exercises that aim at correcting these deficits, such as movement training, were suggested to improve symptoms and functional limitations. To date, few studies have assessed outcomes following an intervention focused on movement training.

Objectives: Evaluate the effects of a rehabilitation program based on movement training on symptoms, functional limitations and AHD in individuals with SPS.

Design: Prospective single group pre-post design. Methods: Twenty-five participants with SPS (SPS group) participated in a 6-week program. Twenty asymptomatic volunteers were recruited for normative AHD values (control group). Outcomes of both groups were evaluated at baseline and 6 weeks, i.e. immediately following intervention for the SPS group. Changes in symptoms and functional limitations for SPS group were assessed using the Western Ontario Rotator Cuff index (WORC) and Disability of the Arm Shoulder and Hand questionnaire (DASH). Changes in AHD for both groups were assessed using ultrasonographic measures.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 29
• Est. completion date: September 2014
• Est. primary completion date: May 2014
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• painful arc of movement during flexion or abduction

• positive Neer or Kennedy-Hawkins impingement signs

• pain on resisted lateral rotation, abduction or empty can test.

Exclusion Criteria:

• previous shoulder surgery

• shoulder pain reproduced by neck movement

• clinical signs of full-thickness RC tears

• shoulder capsulitis.

Study Design

Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Shoulder Impingement Syndrome
• Syndrome

Intervention

Other:
• Rehabilitation program
Movement training: To re-educate control of movement, exercises of increasing difficulty in terms of movement plane, range of motion, speed and resistance were performed. Strengthening: Using extremities weight, free weights or elastic bands, scapulothoracic and scapulohumeral strengthening was performed to increase strength and control of shoulder muscles. Stretching & Manual Therapy: These modalities, performed only if needed, were aimed at addressing stiffness of posterior and inferior glenohumeral capsule and pectoralis minor. Patient education: Participants received education regarding posture and body mechanics. They were instructed on preferred shoulder positioning during sleep, activities, work and sports

Locations

Country	Name	City	State
Canada	Centre for Interdisciplinary Research in Rehabilitation and Social Integration	Quebec City	Quebec

Sponsors (1)

Lead Sponsor	Collaborator
Laval University

Country where clinical trial is conducted

Canada, 

References & Publications (4)

Desmeules F, Minville L, Riederer B, Côté CH, Frémont P. Acromio-humeral distance variation measured by ultrasonography and its association with the outcome of rehabilitation for shoulder impingement syndrome. Clin J Sport Med. 2004 Jul;14(4):197-205. — View Citation

Ngomo S, Mercier C, Bouyer LJ, Savoie A, Roy JS. Alterations in central motor representation increase over time in individuals with rotator cuff tendinopathy. Clin Neurophysiol. 2015 Feb;126(2):365-71. doi: 10.1016/j.clinph.2014.05.035. Epub 2014 Jun 21. — View Citation

Roy JS, Moffet H, Hébert LJ, Lirette R. Effect of motor control and strengthening exercises on shoulder function in persons with impingement syndrome: a single-subject study design. Man Ther. 2009 Apr;14(2):180-8. doi: 10.1016/j.math.2008.01.010. Epub 2008 Mar 20. — View Citation

Roy JS, Moffet H, McFadyen BJ. The effects of unsupervised movement training with visual feedback on upper limb kinematic in persons with shoulder impingement syndrome. J Electromyogr Kinesiol. 2010 Oct;20(5):939-46. doi: 10.1016/j.jelekin.2009.10.005. Epub 2009 Nov 8. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Symptoms and functional limitations - Upper limb	Upper limb symptoms and functional limitations were assessed using the Disability of the Arm Shoulder and Hand (DASH) questionnaire. DASH has 30 items that measures upper limb physical disability and symptoms. Final scores range from 0 to 100 (most severe disability).	week 6	No
Secondary	Symptoms and functional limitations - Shoulder	Shoulder symptoms and functional limitations was assessed using the Western Ontario Rotator Cuff (WORC) index. The WORC is a disease-specific questionnaire designed for patients with RC disorders. Scores vary from 0 to 100 (high functional status).	week 6	No
Secondary	Ultrasonographic measurements of acromiohumeral distance (AHD)	Measurement of AHD is defined as the tangential distance between the bony landmarks of humeral head and inferior edge of acromion, corresponding to the anterior outlet of subacromial space.Measurements were taken in a sitting position with the arm at rest, and at 45° and 60° of active abduction.	week 6	No