Back to resultsThe Effect of Scapular Proprioceptive Neuromuscular Facilitation Techniques on Pain and Functionality in Subacromial Impingement Syndrome
Primary Purpose
Shoulder Impingement Syndrome
Status
Completed
Phase
Not Applicable
Locations
Turkey
Study Type
Interventional
Intervention
Scapular PNF
Exercise program
Sponsored by
About this trial
This is an interventional treatment trial for Shoulder Impingement Syndrome focused on measuring Proprioceptive Neuromuscular Facilitation, Shoulder pain
Eligibility Criteria
Inclusion Criteria:
- Aged between 20 and 60
- Diagnosed with SIS by MRI and clinical examination and a specialist physician
- Positive impingement tests (Hawkings, Neer and Jobe test) or painful motion arc (60 ° -120 °)
- Unilateral shoulder pain that has been going on for at least 3 months
- Signed voluntary consent form
Exclusion Criteria:
- Diagnosed with adhesive capsulitis or massive rotator cuff tear
- Having undergone upper limb surgery
- Presence of rheumatological systemic diseases
- Presence of Glenohumeral instability
- Having a neurological disease affecting the upper extremity
- Diagnosed with cervical radiculopathy
- Degenerative joint disorders
- Having communication problems
- Steroid injection therapy or physiotherapy in the past 6 months have been rehabilitated
Sites / Locations
- Istanbul Aydin University
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Group1 (PNF group)
Group 2 (Exercise group)
Arm Description
Scapular PNF and exercise program was applied to the PNF group.
Exercise program was applied to the exercise group
Outcomes
Primary Outcome Measures
Change from Baseline Pain intensity of the patients at 6 weeks
Pain intensity of the patients at rest, during activity and at night was assessed using the VAS; Visual Analog Scale. In this evaluation, individuals were told that the number "0" on the 10 cm long horizontal line expresses "no pain", and the number "10" indicates "unbearable pain" and that individuals should mark their intensity of pain on this line.
Change from Baseline Functional Status of the patients at 6 weeks
The functional status of the patients were evaluated by The Disabilities of the Arm, Shoulder and Hand (DASH). DASH is a scale consisting of 30 questions that question the functional status and symptoms used in musculoskeletal disorders of the upper extremity.The number of Likert scale (1: no difficulty, 5: I can not do at all) is used in answering the questions and the total score obtained is between 0 and 100.
Secondary Outcome Measures
Shoulder Range of Motion (ROM)
EHA evaluations of flexion, abduction, internal rotation and external rotation of the shoulder joint were performed in the supine position using the digital goniometer.
Pain Pressure Threshold (PPT)
Pressure pain threshold was evaluated using the Algometer (dolorimeter).
Scapular dyskinesis
Scapular Dyskinesis was evaluated with "The Lateral Scapular Slide Test (LSKT)". In this test, the distance of the inferior angle of the scapula to the nearest spinous process at 3 different positions (0°, 40-45°, 90°) is measured, and a difference of 1 cm or more between the two sides in any of the three positions is considered positive for scapular dyskinesis.
Active trigger points
Active trigger points were evaluated by palpation method according to Travell and Simons criteria. Scalene, upper trapezius, levator scapula, supraspinatus, infraspinatus, subskapularis, teres minor, teres major, deltoid anterior, middle and posterior group fibers, pectoralis major, pectoralis minor, biceps brachii muscles were evaluated with palpation method in terms of trigger point presence.
Emotional state
The emotional states of the cases were evaluated using the Hospital Anxiety and Depression Scale (HAD), which consists of 14 questions. (HAD). This scale has a 7-question anxiety (HAD-A) subscale that evaluates the anxiety state, and a 7-question depression (HAD-D) subscale that evaluates the state of depression, and a four-point likert scale is used to answer the questions. For the total score of each sub-score, 0-7 points are normal, 8-10 points are at the border, and 11 points are defined as abnormal
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04273568
Brief Title
The Effect of Scapular Proprioceptive Neuromuscular Facilitation Techniques on Pain and Functionality in Subacromial Impingement Syndrome
Official Title
The Effect of Scapular Proprioceptive Neuromuscular Facilitation Techniques on Pain and Functionality in Subacromial Impingement Syndrome
Study Type
Interventional
2. Study Status
Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
March 1, 2019 (Actual)
Primary Completion Date
August 30, 2019 (Actual)
Study Completion Date
August 30, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Tuğba Akgüller
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The aim of this study was to investigate the effects of scapular proprioceptive neuromuscular facilitation (PNF) techniques applied in addition to exercise therapy in patients with Subacromial impingement syndrome (SIS) on pain, pressure pain threshold (PPT), range of motion (ROM), functionality, scapular dyskinesis, active trigger points and emotional state.
Detailed Description
32 patients between the ages of 20-60 diagnosed with SIS were included in the study.
The patients were randomly divided into two groups. The exercise group received an exercise program of 12 sessions. Scapular PNF techniques were applied to the PNF group with the same exercise program. Patients were evaluated twice; one before and one after 6 weeks of treatment; using Visual Analogue Scale (VAS) for pain, algometer for PPT, digital goniometer for range of motion (ROM), The Disabilities of Arm, Shoulder and Hand (DASH) for functional status, lateral scapular slide test (LSST) for scapular dyskinesis, Travell and Simons criteria for trigger point and Hospital Anxiety and Depression Scale (HADS) for emotional state. At the end of treatment patient satisfaction was evaluated with Global Change Scale.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Shoulder Impingement Syndrome
Keywords
Proprioceptive Neuromuscular Facilitation, Shoulder pain
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
32 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Group1 (PNF group)
Arm Type
Experimental
Arm Description
Scapular PNF and exercise program was applied to the PNF group.
Arm Title
Group 2 (Exercise group)
Arm Type
Active Comparator
Arm Description
Exercise program was applied to the exercise group
Intervention Type
Other
Intervention Name(s)
Scapular PNF
Intervention Description
Rhythmic initiation and repetitive stretching techniques in scapula anterior elevation-posterior depression and anterior depression-posterior elevation patterns were applied twice a week for 6 weeks.
Intervention Type
Other
Intervention Name(s)
Exercise program
Intervention Description
An exercise program consisting of exercises used in the conservative treatment of shoulder impingement syndrome for both groups was applied twice a week for 6 weeks.
Primary Outcome Measure Information:
Title
Change from Baseline Pain intensity of the patients at 6 weeks
Description
Pain intensity of the patients at rest, during activity and at night was assessed using the VAS; Visual Analog Scale. In this evaluation, individuals were told that the number "0" on the 10 cm long horizontal line expresses "no pain", and the number "10" indicates "unbearable pain" and that individuals should mark their intensity of pain on this line.
Time Frame
Baseline and 6 weeks
Title
Change from Baseline Functional Status of the patients at 6 weeks
Description
The functional status of the patients were evaluated by The Disabilities of the Arm, Shoulder and Hand (DASH). DASH is a scale consisting of 30 questions that question the functional status and symptoms used in musculoskeletal disorders of the upper extremity.The number of Likert scale (1: no difficulty, 5: I can not do at all) is used in answering the questions and the total score obtained is between 0 and 100.
Time Frame
Baseline and 6 weeks
Secondary Outcome Measure Information:
Title
Shoulder Range of Motion (ROM)
Description
EHA evaluations of flexion, abduction, internal rotation and external rotation of the shoulder joint were performed in the supine position using the digital goniometer.
Time Frame
Baseline and 6 weeks
Title
Pain Pressure Threshold (PPT)
Description
Pressure pain threshold was evaluated using the Algometer (dolorimeter).
Time Frame
Baseline and 6 weeks
Title
Scapular dyskinesis
Description
Scapular Dyskinesis was evaluated with "The Lateral Scapular Slide Test (LSKT)". In this test, the distance of the inferior angle of the scapula to the nearest spinous process at 3 different positions (0°, 40-45°, 90°) is measured, and a difference of 1 cm or more between the two sides in any of the three positions is considered positive for scapular dyskinesis.
Time Frame
Baseline and 6 weeks
Title
Active trigger points
Description
Active trigger points were evaluated by palpation method according to Travell and Simons criteria. Scalene, upper trapezius, levator scapula, supraspinatus, infraspinatus, subskapularis, teres minor, teres major, deltoid anterior, middle and posterior group fibers, pectoralis major, pectoralis minor, biceps brachii muscles were evaluated with palpation method in terms of trigger point presence.
Time Frame
Baseline and 6 weeks
Title
Emotional state
Description
The emotional states of the cases were evaluated using the Hospital Anxiety and Depression Scale (HAD), which consists of 14 questions. (HAD). This scale has a 7-question anxiety (HAD-A) subscale that evaluates the anxiety state, and a 7-question depression (HAD-D) subscale that evaluates the state of depression, and a four-point likert scale is used to answer the questions. For the total score of each sub-score, 0-7 points are normal, 8-10 points are at the border, and 11 points are defined as abnormal
Time Frame
Baseline and 6 weeks
Other Pre-specified Outcome Measures:
Title
Patient Satisfaction: Global Rating of Change (GRC) scale
Description
Patient Satisfaction was assessed Global Rating of Change (GRC) scale. The scale used included 5 points (-2: I am much worse. -1: I am worse, 0: I am the same, +1: I am better, +2: I am much better).
Time Frame
At the end of the 6-weeks treatment
10. Eligibility
Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Aged between 20 and 60
Diagnosed with SIS by MRI and clinical examination and a specialist physician
Positive impingement tests (Hawkings, Neer and Jobe test) or painful motion arc (60 ° -120 °)
Unilateral shoulder pain that has been going on for at least 3 months
Signed voluntary consent form
Exclusion Criteria:
Diagnosed with adhesive capsulitis or massive rotator cuff tear
Having undergone upper limb surgery
Presence of rheumatological systemic diseases
Presence of Glenohumeral instability
Having a neurological disease affecting the upper extremity
Diagnosed with cervical radiculopathy
Degenerative joint disorders
Having communication problems
Steroid injection therapy or physiotherapy in the past 6 months have been rehabilitated
Facility Information:
Facility Name
Istanbul Aydin University
City
Istanbul
ZIP/Postal Code
34295
Country
Turkey
12. IPD Sharing Statement
Learn more about this trial
The Effect of Scapular Proprioceptive Neuromuscular Facilitation Techniques on Pain and Functionality in Subacromial Impingement Syndrome
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