Effects of a Scapular-focused Exercise Protocol

NOVA School of Science and Technology ı FCT NOVA

Status

Completed

Conditions

Rotator Cuff Syndrome of Shoulder and Allied Disorders

Treatments

Other: Scapular-focused exercise protocol without EMGBF

Other: Scapular-focused exercise protocol with EMGBF

Other: Control Therapy

Study type

Interventional

Funder types

Other

Identifiers

NCT05516186

18/2022 ESSAlcoitão

Details and patient eligibility

About

Background: Current clinical practice still lacks consistent evidence in the physiotherapy management of Rotator cuff related pain syndrome (RCS). The purpose of this trial was to compare the effectiveness of a scapular-focused treatment with and without real-time electromyographic biofeedback (EMGBF) to a control therapy in patients with RCS.

Methods: 60 patients with RCS were divided into three groups: scapular-focused exercise protocol group (P_G n=20), scapular-focused exercise protocol with EMGBF group (P+EMGBF_G n=20) and control therapy group (CT_G n=20). Values of pain and function [Shoulder Pain and Disability Index (SPADI) questionnaire, complemented by the Numeric Pain Rating Scale (NPRS) and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire], scapular stabilizer neuromuscular control (SSNC), scapular stabilizer activation onset (SSAO), dynamic scapular alignment, range of motion (ROM) and glenohumeral flexor and abductor muscle strength (GMS) were assessed at baseline and after 6-weeks and compared within and between groups.

Full description

In order to advance the understanding of the value of scapular-focused exercise for rotator cuff related syndrome, a new trial was designed with the main objective of comparing pain and function outcomes between three different treatment protocols for patients with RCS:

P_G - Scapular-focused exercise protocol without electromyographic biofeedback (EMGBF) P+EMGBF_G - Scapular-focused exercise protocol supported by real-time EMGBF CT_G - Control therapy group with manual therapy (glenohumeral joint physiologic and accessory mobilization) , massage to reduce upper trapezius (UT) stiffness, and shoulder rotation strengthening into external rotation Every outcomes was assessed at the beginning of treatment, and then, weekly until completed 6 weeks of treatment.

Enrollment

60 patients

Sex

All

Ages

18 to 60 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

1- age between 18 and 60 years; 2 - primary complaint of shoulder pain 3 - RCS clinical diagnosis

Exclusion criteria

- neurological symptoms;
- positive thoracic outlet syndrome (screened with Allen's and Adson's tests);
- history of shoulder surgery or fracture;
- structural injuries confirmed by imaging (e.g. ligaments and labrum);
- symptoms reproduced by cervical examination;
- unable to commit to scheduled treatments;
- Anti-inflammatory drug use

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

60 participants in 3 patient groups

Scapular-focused exercise protocol supported by real-time EMGBF

Experimental group

Description:

The scapular-focused exercise protocol followed the protocol described by dos Santos et al. (2021). The protocol uses sequential stages of motor relearning (cognitive, associative, and autonomous) as a framework, while promoting the integration of local and global muscle function in weekly sessions divided into three phases. The main purpose of the protocol is to increase scapular neuromuscular activity and control.

Treatment:

Other: Scapular-focused exercise protocol without EMGBF

Other: Control Therapy

Scapular-focused exercise protocol without EMGBF

Experimental group

Description:

The same protocol described above was applied without EMGBF

Treatment:

Other: Scapular-focused exercise protocol with EMGBF

Other: Control Therapy

Control therapy group

Other group