Active clinical trials for "Shoulder Impingement Syndrome"

Shoulder arthroscopy is one of the most commonly performed orthopaedic procedures and it is often done with the patient in the upright, or beach chair position (BCP). There have been multiple reported complications associated with the BCP, including cerebral ischemia, loss of vision, ophthalmoplegia, stroke, and even death. It has been reported that patients with a body mass index (BMI) of 34 or greater are as much as 12 times more likely to experience cerebral desaturation events (CDEs) compared to non-obese controls. CDEs in the upright position are hypothesized to be partially related to reduced cardiac preload due to venous pooling in the lower extremities which is exaggerated in obese patients. This prospective observational study aims to determine if the use of compression stockings in obese patients undergoing shoulder arthroscopy in the BCP can reduce the incidence, frequency, or magnitude of CDEs experienced by the patient

Injection with corticosteroid is one of the most common non-operative interventions in the treatment of subacromial impingement; however, its use is limited by its potential side effects (e.g. tendon rupture, subcutaneous atrophy, articular cartilage changes). The objective of this study was to compare the efficacy of subacromial injection of triamcinolone compared to injection of ketorolac. Thirty-two patients diagnosed with external shoulder impingement syndrome were included in this double-blinded randomized controlled clinical trial. Each patient was randomized into the Steroid group or NSAID group.

Limited range-of-motion (ROM) is a common problem after reverse shoulder arthroplasty (RSA). The occurrence and magnitude depend on both surgical and patient-related factors. The most important surgical factor is the occurrence of impingement, which implicates collision between the humeral implant or bone and the scapula, limiting further motion. Patient-related factors such as scapula geometry and muscle function and activation also play an important role. Surgeons have to account for these factors when planning and implanting a RSA. Software models can support the surgeon during preoperative planning by using imaging data to simulate the ROM of a patient's shoulder after RSA. These software models allow for adaptation of the implant position during preoperative planning and, by this optimize the postoperative ROM. However, the models currently developed are limited in terms of ROM simulation and the factors the models take into account.

Background and Purpose: Rock climbing has been a popular sport in recent years. Rock climbing includes various open-chain and closed-chain arm movements. Overhead reaching and pull-up are the basic rock climbing elements heavily involving upper extremities. Different inclination of the wall and terrain also demand sufficient range of motion and strength of the trunk. Generally overhead reaching and arm elevation may have similar shoulder kinematics, including scapular upward rotation, posterior tilt and external rotation. Arm elevation usually is accompanied with thoracic extension and unilateral lateral flexion and rotation. During pull-up, the scapula rotates downward and externally and tilts anterior. The prevalence of shoulder injuries are about 17%, the second most common among rock climbing injuries. In the shoulder injuries, shoulder labrum lesions and shoulder impingement are the most common. Previous studies have shown that individuals with shoulder impingement syndrome have shown decreased upward and externally rotation during arm elevation, and have limited thoracic extension range of motion and greater kyphotic posture. However, a previous study found no difference in the scapular kinematics and scapular muscle activation during pull-up in rock climbers with shoulder pain and healthy climbers. The non-significant finding may be due to that the pure pull-up may not mimic climbing tasks, in which the shoulder and trunk need to adapt different inclination of the wall. Therefore, the purpose of this study is to investigate the kinematics and muscle activation of the thoracic spine and shoulder in rock climbers with shoulder pain during climbing tasks with different reaching angles. Methods: Thirty sport climbers with shoulder pain and 30 healthy climbers matched with gender, age, and dominant hand will be recruited in this study. Testing tasks will include arm elevation in the scapular plane, overhead reaching to the target 15° backward to the frontal plane, pull-up with overhead reaching forward and backward. Thoracic and shoulder kinematics will be collected using an electromagnetic tracking system. The upper trapezius, lower trapezius, serratus anterior, latissimus dorsi, and erector spinae were collected with surface electromyography (EMG). A two-way mixed ANOVA will be used to determine differences between groups in the kinematics and EMG measures at the different arm elevation angles for the testing tasks.

Volleyball players repetitively place the arm into extreme positions, and thus expose the athletes' shoulders to a large load and increase the risk of injuries. The shoulder complex is identified as one of the most injured joints in volleyball sports. Although many studies have revealed alterations in the function, morphology and biomechanics of the shoulder complex in volleyball players with shoulder pain, some researchers suggested that a smooth energy transfer from the axial skeleton, through the shoulder complex, to the arm and hand is crucial for overhead sports performance and injury prevention, with little evidence showing the link between trunk muscle performance and shoulder pain in volleyball players. Therefore, the main purposes of present study are (1) to compare the trunk muscle performance (muscle strength, power and endurance) in volleyball players with and without subacromial impingement syndrome (SIS); (2) to compare trunk and shoulder muscles activity during spiking in volleyball players with and without SIS.

Primary aim of this study is to investigate wether an evidence-based physiotherapy regimen is more effective than standard care in patients referred for arthroscopic surgery of the shoulder. It is hypothesized that a multimodal physiotherapy regimen will relieve pain, improve shoulder function and reduce the need for subacromial decompression surgery of the shoulder compared to standard care/wait and see controls.

Shoulder pain is one of the most common musculoskeletal complaints in orthopedic practice. Rotator cuff injuries account for up to 70% of pain in the shoulder girdle. There is no clinical study carried out in Brazil comparing cost effectiveness between the open and arthroscopic methods of rotator cuff repair surgery. The present study aims to determine which method of repair of the rotator cuff, open or arthroscopic, has the best cost effectiveness ratio. A randomized clinical trial will be carried out in which patients with symptomatic rotator cuff lesion will be submitted to repair surgery by either open or arthroscopic technique and will be subsequently evaluated.

The shoulder stability has always been related to the rotator cuff complex, although more and more is contemplated the Teres Major muscle and its affectation in the shape of the trigger points within this pathology. As non-invasive measures for the deactivation of these myofascial points, Travell and Simons recommended the pressure maintained along with muscular stretch. Stretching are usually a technique widely used in our practice as physiotherapists and it is necessary to study its effects in the clinic. As an objective we plan to compare the effect of passive stretching in short lever according to the Orthopaedic Manual Therapy concept if it produces better result in the pain, the rank of movement and in the Function, with the effect of stretching by means of a long lever in affected patients of subacromial syndrome. This is a randomized controlled study with blind evaluator approved by the Ethical Committee of the Institut d'Investigació en atenció Primaria Jordi Gol. After checking the inclusion and exclusion criteria, you will be asked, voluntarily, that the patient sign informed consent. The variables will then be valued independent and dependent on the study. It will randomly be assigned to one of the three groups in the study. The 3 groups receive the protocolized treatment for the service they consist of In superficial thermotherapy, an educational talk and kinesitherapy. The intervention groups will receive alternate days, with a total of six sessions, the stretch corresponding to the group to which they have been assigned. In the case of the Long Lever Group, the intervention consists in a rotary stretch through the humerus as a mobile point. And in the case of the Short Lever Group a stretch of translocation through the scapula as a mobile point. The main variables used will be: age, side effects, habits involving the shoulder, pain intensity, pain threshold at pressure and function, among others. The dependent variables will be measured: pain intensity by means of Analogue Scale Visual, the function through the Constant-Murley test, the Movement Range with Goniometer and the Pressure Threshold Pain with a pressure gauge brand Stech.

Subacromial injection is considered one of the best treatments for patients with subacromial impingement syndrome. The subacromial bursa is located between the deltoid muscle and the supraspinatus tendon. It facilitates the gliding of the humeral head through the undersurface of the acromion. If the bursa is thickened, the patient may experience pain when he/she tries to raise the arm. In patients with subacromial impingement due to a thickened subacromial bursa, the physician can precisely inject the medication into the bursa using ultrasound guidance. Use of ultrasound guidance has been proven to yield a better effect of pain relief than the technique using guidance. A previous study found that even using ultrasound guidance to deliver medication, there were still many patients suffering from initial treatment failure or recurrence after the first successful injection. Because the pathophysiological mechanism of subacromial impingement is complexed, the proximal biceps tendon may be involved but is often ignored. Recently, the investigators published a randomized controlled trial comparing the effect of dual-target injection (proximal biceps tendon and subacromial bursa) with the standard subacromial injection in patients with subacromial impingement syndrome, and found that the dual target approach was safe and had a longer effective duration than the standard subacromial injection. In this regard, the investigators will conduct a longitudinal follow-up study to examine the long-term effectiveness of the dual-target corticosteroid injection for subacromial impingement syndrome.

In this study, the goal is to find out if the clinicCompanion™ is effective in measuring range of motion when compared to the goniometer. Currently, the goniometer is an approved device to measure range of motion by the FDA, but the clinicCompanion™ is not.