Teres Major Muscle and Subacromial Impingement Syndrome

Effectiveness of Teres Major Muscle Specific Treatment in Patients Diagnosed With Subacromial Impingement Syndrome

There is not a clear understanding of the origin of symptoms perceived by patients with impingement of the soft tissue structures of the subacromial space. Tendinopathy, tendon rupture or other pathologies, are present in asymptomatic subjects and subjects with symptoms and structural integrity can also be found.

Patients diagnosed with subacromial impingement syndrome frequently have myofascial trigger points in the teres major muscle. Travell and Simons reported that the symptoms caused by trigger points in this muscle are similar to those experienced by patients diagnosed with impingement syndrome, but a literature search provides few results regarding relationship between subacromial impingement syndrome and presence of myofascial trigger points in the teres major muscle.

This study aims to provide evidence of the results that can be obtained with a specific approach of teres mayor muscle by two manual techniques, Trigger Point Pressure Release and Diacutaneous Fibrolysis, in subjects with subacromial impingement syndrome, a condition that still representing both a diagnostic and therapeutic challenge. Secondary objective is to compare the outcomes between both techniques to select for each patient the most appropriate to their needs and characteristics.

Study Overview

• Status: Unknown
• Conditions: Subacromial Impingement Syndrome; Trigger Points in Teres Major Muscle
• Intervention / Treatment: Device: Diacutaneous Fibrolysis; Other: Protocolized physiotherapy; Other: Trigger Point Pressure Release

• Study Type: Interventional
• Enrollment (Anticipated): 96
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Barcelona
    • Cornellà de Llobregat, Barcelona, Spain, 08840
      • Recruiting
      • Catalan Health Institut. Sant Ildefons Rehabilitation Service
      • Contact: Martín Barra; Email: martinbarra@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Age 18 years and over
• Clinical diagnosis of Subacromial Impingement Syndrome.
• Detectable trigger points in teres major muscle.
• Sign informed consent form.

Exclusion Criteria:

• Diacutaneous Fibrolysis contraindications
• Previous shoulder surgery (<1year)
• Language barriers or cognitive issues that limit their ability to provide informed consent and participate in research.
• Patients with a pending litigation or court claim.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Fibrolysis Group; Actual Diacutaneous Fibrolysis and protocolized physiotherapy	Device: Diacutaneous Fibrolysis; Applied only around teres major muscle.; Other: Protocolized physiotherapy; Exercises, TENS and cryotherapy
Experimental: Pressure Group; Trigger Point Pressure Release and protocolized physiotherapy	Other: Protocolized physiotherapy; Exercises, TENS and cryotherapy; Other: Trigger Point Pressure Release; Applied only in teres major muscle trigger points.
Active Comparator: Control Group; Protocolized physiotherapy	Other: Protocolized physiotherapy; Exercises, TENS and cryotherapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Pain intensity (Using a VAS)	Using a VAS	Change from baseline to 3 weeks.
Change in Functional capacity (Abbreviated Constant-Murley score)	Abbreviated Constant-Murley score	Change from baseline to 3 weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Active Range of Motion	Flexion, extension, abduction, external rotation and internal rotation	Change from baseline to 3 weeks.
Patient perception of change (Global Rating of Change scale)	Global Rating of Change scale	3 weeks after recruitment

Collaborators and Investigators

• Sponsor: Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina
• Investigators: Principal Investigator: Martín Barra, IDIAP Jordi Gol

Study record dates

Study Major Dates

• Study Start: November 1, 2014
• Primary Completion (Anticipated): October 1, 2015
• Study Completion (Anticipated): December 1, 2015

Study Registration Dates

• First Submitted: February 10, 2015
• First Submitted That Met QC Criteria: February 23, 2015
• First Posted (Estimate): February 27, 2015

Study Record Updates

• Last Update Posted (Estimate): February 27, 2015
• Last Update Submitted That Met QC Criteria: February 23, 2015
• Last Verified: February 1, 2015

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Wounds and Injuries; Disease; Joint Diseases; Musculoskeletal Diseases; Rupture; Shoulder Injuries; Tendon Injuries; Syndrome; Rotator Cuff Injuries; Shoulder Impingement Syndrome
• Other Study ID Numbers: P14/033