The Most Effective Intervention for Reducing Posterior Shoulder Tightness Acutely in the Post-operative Population

Nova Southeastern University (NSU)

Status: Completed

Conditions: Postoperative Posterior Shoulder Tightness

Treatments: Other: Horizontal Adduction Stretch and Pendulums; Other: Modified Sleeper Stretch and Pendulum

Study type: Interventional

Funder types: Other

Identifiers

NCT01810211

NovaSEU

Details and patient eligibility

About

This study will look at which, if any, active stretching procedure is most effective at correcting posterior shoulder tightness (PST) in the post-operative population. Posterior shoulder tightness can influence shoulder mobility and function within both a symptomatic and an asymptomatic population. There are previous studies that have examined the effectiveness of different active stretching procedures and their ability to correct PST but only in the asymptomatic population. As clinicians it will be helpful to investigate their effect within a symptomatic population in order to prescribe appropriate and effective stretches within an individual's home exercise program. The study design is a double blinded randomized control trial. During evaluation a passive measurement of PST and internal rotation will be performed. Another therapist, blinded to the measurements, will randomly select which subgroup the individual will be placed in for the first three individuals and this sequence will be followed for the remainder of the participants. At this time the therapist will instruct the individual on the corresponding exercise which they will perform in front of that therapist. The individual will perform this exercise one more time that day and twice the following day and once again upon follow up prior to having internal rotation and PST measured once again. At this point this will be the conclusion of that individuals involvement in the study.

Null Hypothesis1: Stretches are no more effective than no treatment for reducing PST acutely in the post-operative shoulder population.

Hypothesis1: Stretches are more effective than no treatment for reducing PST acutely in the post-operative population.

Null Hypothesis2: There is no significant difference in the reduction of PST between the horizontal adduction stretch and the modified sleeper stretch acutely in the post-operative shoulder population.

Hypothesis2: There is a significant difference in the reduction of PST between the horizontal adduction stretch and the modified sleeper stretch acutely in the post-operative shoulder population.

Enrollment: 63 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• arthroscopic shoulder surgery within the past two weeks preceding data collection with
• no surgical complications
• age 18-65.

Exclusion criteria

• total shoulder arthroplasty
• hemi shoulder arthroplasty
• open rotator cuff repair
• shoulder fracture fixations
• those that are unable to perform interventions and or tolerate measurement positions
• those seeking an initial evaluation after two weeks from the date of the surgical procedure.
• younger than 18
• older than 65

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

63 participants in 3 patient groups

Horizontal Adduction Stretch and Pendulums

Experimental group

Description:

Horizontal Adduction Stretch- Individual standing with their operative scapula against a wall and rotating toward the side to be stretched to stabilize scapula and the operative arm is relaxed. The opposite hand is placed under the elbow of the involved extremity and assists the operative shoulder into horizontal adduction attempting to bring the hand to the opposite shoulder. Pendulum -Individual leans over with support from uninvolved extremity placed on an immovable object while involved extremity is relaxed. The individual than rotates their hips in order to allow the involved extremity to create small circles passively in a clockwise direction.

Treatment:

Other: Horizontal Adduction Stretch and Pendulums

Modified Sleeper Stretch and Pendulum

Experimental group

Description:

Modified Sleeper Stretch: Individual in supine with operative shoulder abducted to approximately 45 degrees and elbow at 90 degrees of flexion with neutral rotation of the glenohumeral joint. The individual then places other hand on the wrist of the involved extremity and passively moves the glenohumeral joint into internal rotation. Pendulum Exercise: Individual leans over with support from uninvolved extremity placed on an immovable object while involved extremity is relaxed. The individual than rotates their hips in order to allow the involved extremity to create small circles passively in a clockwise direction.

Treatment:

Other: Modified Sleeper Stretch and Pendulum

Pendulum Exercise

No Intervention group

Description:

Pendulum Exercise: Individual leans over with support from uninvolved extremity placed on an immovable object while involved extremity is relaxed. The individual than rotates their hips in order to allow the involved extremity to create small circles passively in a clockwise direction.