The Influence of Eccentric Training on the Volume and Vascularisation of the Rotator Cuff in Patients With Rotator Cuff Tendinopathy and Healthy Subjects

Patients with rotator cuff tendinopathy make up a large part of the population in physiotherapy practice. The rotator cuff, a shoulder muscle group, plays an important role in causing pain. Tendons suffer large compression and friction, which can lead to degeneration of these tendons. Rehabilitation often leads to unsatisfying results.

In Achilles and patella tendinopathy, a new training program called eccentric training has shown very good results. Eccentric training contains exercises during which a force has to be resisted while the muscle lengthens instead of shortens. This would have a larger influence on tendon tissue. Some small studies also show promising results of eccentric training in patients with rotator cuff tendinopathy but the mechanisms behind these results remain unclear.

To investigate this, 30 patients with rotator cuff tendinopathy and 30 healthy subjects will be evaluated before and immediately after performing the exercise. Three measurements will be done: ultrasonographic measurement of tendon thickness, power Doppler imaging and measurement of microcirculation around the tendon with Oxygen to see. All measurements are non-invasive, pain free and without risks for the human body.

Study Overview

• Status: Completed
• Conditions: Rotator Cuff Tendinopathy
• Intervention / Treatment: Behavioral: Eccentric exercise

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Belgium
  • Ghent, Belgium, 9000
    • University Hospital Ghent

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 40 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria Patients:

• Male/ Female
• 18-40 years old
• Unilateral shoulder pain for at least 3 months
• Pain of at least 3/10 on a visual analogue scale
• Painful arc or pain at end range abduction
• 2/3 impingement tests positive
• 2/4 resistance tests positive
• Pain at insertion rotator cuff

Exclusion Criteria Patients:

• Spurling test positive
• Shoulder surgery in the past
• Osteoarthritis shoulder
• Full thickness ruptures

Inclusion Criteria Healthy subjects:

• Male/ Female
• 18-40 years old

Exclusion Criteria Healthy subjects:

• Shoulder pain during the last 3 months
• Shoulder surgery in the past
• Neck pain or disability
• Systemic disease (e.g. Marfan, Ehlers Danlos,…)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Healthy subjects	Behavioral: Eccentric exercise; Patients and healthy subjects will perform an eccentric exercise during which a weight is lifted along the body and lowered with an extended arm at a slow speed. Weight is determined, based on pain in patients and based on force in healthy subjects.
Active Comparator: Rotator cuff tendinopathy	Behavioral: Eccentric exercise; Patients and healthy subjects will perform an eccentric exercise during which a weight is lifted along the body and lowered with an extended arm at a slow speed. Weight is determined, based on pain in patients and based on force in healthy subjects.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Tendon thickness measurement	Grey scale ultrasound examination is used.	After 30 minutes rest, before performing the exercise.
Tendon vascularisation examination.	Power Doppler ultrasound examination is used.	After 30 minutes rest, before performing the exercise.
Microcirculation around the tendon examination.	Oxygen to see (spectrophotometry and laser Doppler) will be used.	After 30 minutes rest, before performing the exercise.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Tendon thickness measurements.	Grey scale ultrasound examination is used.	10 minutes after performing the exercise.
Tendon vascularisation examination.	Power Doppler ultrasound examination is used.	10 minutes after performing the exercise.
Microcirculation around the tendon examination.	Oxygen to see (spectrophotometry and laser Doppler) will be used.	10 minutes after performing the exercise.

Collaborators and Investigators

• Sponsor: University Ghent
• Collaborators: Fund for Scientific Research, Flanders, Belgium
• Investigators: Principal Investigator: Ann Cools, MD, PhD, University Ghent

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2012
• Primary Completion (Actual): April 1, 2015
• Study Completion (Actual): June 1, 2015

Study Registration Dates

• First Submitted: August 23, 2011
• First Submitted That Met QC Criteria: August 25, 2011
• First Posted (Estimate): August 26, 2011

Study Record Updates

• Last Update Posted (Actual): November 19, 2021
• Last Update Submitted That Met QC Criteria: November 18, 2021
• Last Verified: November 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Wounds and Injuries; Musculoskeletal Diseases; Muscular Diseases; Tendon Injuries; Metaplasia; Tendinopathy; Neovascularization, Pathologic
• Other Study ID Numbers: 2011/482