Therapeutic Progressive Exercise on Shoulder Impingement Syndrome
Shoulder Impingement, Tendinopathy
About this trial
This is an interventional treatment trial for Shoulder Impingement focused on measuring shoulder impingement syndrome, tendinopathy, exercise
Eligibility Criteria
Inclusion Criteria:
- Subjects older than 18 years.
- Subjects previously diagnosed with shoulder impingement syndrome.
- Presence of 3 of the following sings: impingement sign according to Neer and to Hawking-Kennedy, positive result on Jobes test, painful arc, and positive result on Patte's manoeuvre.
Exclusion Criteria:
- Findings of spinal radiculopathy.
- General neck and shoulder pain.
- Symptoms of frozen shoulder.
- Pregnancy.
- Fybromyalgia.
- Suspected polyarthritis.
- Chronic pain syndrome.
- Altered blood coagulation.
- Consumption of anticoagulants, opioids or antiepileptics.
- Drug intakes.
- Alcohol intakes higher than 27.4 grams for men or 13.7 grams for women.
- Allergies.
- Cancer.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Neuromuscular resistance exercise group
Control exercise group
Subjects will develop an innovator program consisting in the performance of exercises of increasing difficulty, with movements based on functional tests to analyze the subjects' neuromuscular capacities. Participants will attend to 80 individual, face-to-face physiotherapy sessions, including both supervised and semi-supervised monitoring. From the total, a minimum of 15 sessions will be supervised, including 6 sessions to teach and monitor the exercises, and 9 sessions to perform the tests in order to quantify the load; 37 sessions will be semi-supervised, where subjects will perform the exercises independently, but with the presence of an instructor; additionally, the remaining 28 sessions will consist in non-supervised aerobic work at a 70-80% from maximum heart rate, obtained according to the methodology of Tanaka et al.
This program will be based on a home exercise protocol considering painful sensation and self-perceived stability as progression criteria: regarding pain management, exercises will be planned in a way that increased pain after their performance reverts to before-exercise levels prior to the next session; regarding self-perceived stability, participants will be asked to maintain a constant sensation of joint stability and control during the execution of the exercises. Participants will perform shoulder rotations (external and internal) and abduction up to 30º by using elastic bands. The resistance of the band will be adjusted by the physiotherapist so that participants perceive the exercises as demanding enough but not too unpleasant, being able to complete the 10 repetitions before taking the rest. Likewise, exercises will progress until a maximum of 90º of shoulder abduction.