Overhead Perturbation Training for Glenohumeral Joint Instability (OPT)
Exercise Movement Techniques, Shoulder Pain, Glenohumeral Subluxation
About this trial
This is an interventional treatment trial for Exercise Movement Techniques focused on measuring Overhead perturbation training; instability, glenohumeral joint
Eligibility Criteria
Inclusion Criteria: A clinical presentation indicative of glenohumeral joint functional instability as classified by the Stanmore classification of shoulder instability Polar type II-III (on a continuum between atraumatic structural instability and non-structural, muscle patterning instability (Jaggi and Lambert, 2010)).
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Exclusion Criteria:
- Presence of:
- Connective tissue disorder (Marfan's, Ehlos-Danlos)
- Nerve disorders: cervical radiculopathy +/- myotomal weakness; peripheral neuropathy/ palsy (long thoracic nerve palsy, axillary nerve palsy, suprascapular nerve palsy, etc.); brachial neuritis.
- Neuropathic peripheral sensitivity and/ or central sensitisation
- Post operative orthopaedic intervention < 12 weeks post MRI confirmed full thickness rotator cuff tear
- Distal upper limb/ hand pathology which limits the ability to grasp (including specific pathological signs of lateral epicondylaglia, carpal tunnel syndrome, carpal instability, etc).
- - inability to follow instructions
Sites / Locations
- Guys and St Thomas' NHS Foundation Trust
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Overhead perturbation training technique
Non-perturbed exercise
Patients will undertake a series of exercise positions with the arm elevated above shoulder level with a stimulus applied with a weight and resistance band- such that the glenohumeral joint is exposed to a perturbed stimulus and has to utilise proprioception and motor control to correct arm position. The exercise session will be 45mins in length and occur once per week for 6 weeks.
Patients will undertake a series of exercise positions with the arm elevated above shoulder level with a stimulus applied via a weight held in the hand- such that the glenohumeral joint is exposed to a load but without a perturbation of joint position. The exercise session will be 45mins in length and occur once per week for 6 weeks.