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Completed

NCT Number: NCT04273568

The Effect of Scapular Proprioceptive Neuromuscular Facilitation Techniques on Pain and Functionality in Subacromial Impingement Syndrome

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.

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Key information

Conditions

Shoulder Impingement Syndrome Arthralgia Joint Diseases Musculoskeletal Diseases Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Shoulder Injuries Shoulder Pain Signs and Symptoms Wounds and Injuries

Age range

20 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Istanbul Aydin University

Istanbul, 34295, Turkey (Türkiye)

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Scapular PNF

Other

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.

exercise program

Other

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 outcomes

  1. Change from Baseline Pain intensity of the patients at 6 weeks

    Time frame: Baseline and 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.

  2. Change from Baseline Functional Status of the patients at 6 weeks

    Time frame: Baseline and 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 outcomes

  1. Shoulder Range of Motion (ROM)

    Time frame: Baseline and 6 weeks

    EHA evaluations of flexion, abduction, internal rotation and external rotation of the shoulder joint were performed in the supine position using the digital goniometer.

  2. Pain Pressure Threshold (PPT)

    Time frame: Baseline and 6 weeks

    Pressure pain threshold was evaluated using the Algometer (dolorimeter).

  3. Scapular dyskinesis

    Time frame: Baseline and 6 weeks

    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.

  4. Active trigger points

    Time frame: Baseline and 6 weeks

    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.

  5. Emotional state

    Time frame: Baseline and 6 weeks

    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

Other outcomes

  1. Patient Satisfaction: Global Rating of Change (GRC) scale

    Time frame: At the end of the 6-weeks treatment

    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).

Sponsors and collaborators

Lead sponsor

Tuğba Akgüller

Other

Registry information

Important dates

Study start
2019
Primary completion
2019
Study completion
2019
First posted
Feb 18, 2020
Registry last updated
Feb 18, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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