The Acute Effects of Different Stretching Methods in Individuals With Subacromial Impingement Syndrome

The Acute Effects of Different Stretching Methods on Posterior Shoulder Tightness, Pain, Joint Range of Motion, Subacromial Space and Strength in Individuals Having Subacromial Impingement Syndrome With Glenohumeral Internal Rotation Deficit

The purpose of this study is to investigate and compare the acute effects of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit. Isolytic group will receive isolytic stretching in modified cross body position. Static group will receive static stretching in modified cross body position. Stretching groups will be evaluated before and just after stretching exercise. Control group will receive no stretching. Control group will be evaluated for the first time and then will be waited until the duration of the stretching exercise program. Afterwards, second evaluation will be performed

Study Overview

• Status: Completed
• Conditions: Subacromial Impingement Syndrome; Glenohumeral Internal Rotation Deficit
• Intervention / Treatment: Other: Isolytic stretching group; Other: Static stretching group; Other: Control group

Detailed Description

There is no information in literature about the acute effects of isolytic stretching exercise in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit. The purpose of this study is to investigate and compare the acute effects of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit.

In modified cross body position, static stretching group will perform active-assistive static stretching by the physiotherapist whereas isolytic stretching group will perform active-assistive isolytic stretching. Stretching exercises will be applied five times each for 15 seconds. After each stretching there will be a resting period for 5 seconds. Control group will receive no stretching. They will be handed a brochure about the stretching techniques and its role in injury prevention. Isolytic and static stretching groups will be evaluated before and just after stretching exercise. Control group will be evaluated for the first time and then will be passively waited until the duration of the stretching exercise program (approximately 4-5 min). Afterwards, second evaluation will be performed.

• Study Type: Interventional
• Enrollment (Actual): 69
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • İzmir, Turkey
    • Dokuz Eylul University

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:

• Diagnosis of subacromial impingement syndrome
• Glenohumeral internal rotation range of motion of the affected shoulder should be less than other shoulder and bilateral shoulder internal rotation range of motion difference should be ≥15 º
• Pain with resisted arm elevation or external rotation as well as a minimum of 3 of 5 positive subacromial impingement syndrome tests, painful arc, pain or weakness with resisted external rotation, Neer, Hawkins and Jobe tests .
• Ability to complete the entire study procedure

Exclusion Criteria:

• An inability to elevate the involved arm greater than 140 degree in the scapular plane
• A 50% limitation of passive shoulder range of motion in >2 planes of motion
• Pain >7/10
• A history of fracture to the shoulder girdle
• Systemic musculoskeletal disease
• History of shoulder surgery,
• Glenohumeral instability (positive apprehension, relocation or positive sulcus test) or positive findings for a full thickness rotator cuff tear (positive lag sign, positive drop arm test or marked weakness with shoulder external rotation)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Isolytic stretching group; The participants in this group will receive isolytic stretching in modified cross body position.	Other: Isolytic stretching group; In modified cross body position, isolytic stretching exercises will perform five times each for 15 seconds. After each stretching patient will rest for 5 seconds. When the patient contracts the agonist muscle group with 20% muscle force, the agonist muscle group is stretched at the same time for 2-4 seconds. Afterwards active-assistive stretching is done. Evaluations will be done before and just after stretching exercise.
EXPERIMENTAL: Static stretching group; The participants in this group will receive static stretching in modified cross body position.	Other: Static stretching group; In modified cross body position, active-assistive static stretching exercises will be performed 5 times each for 15 seconds. This stretching exercise is performed 5 times with 5 seconds intervals. Evaluations will be done before and just after stretching exercise.
ACTIVE_COMPARATOR: Control group; The participants in this group will receive no stretching. They will only be evaluated.	Other: Control group; Control group will receive no stretching. They will be handed a brochure about the stretching techniques and its role in injury prevention. Control group will be evaluated for the first time and then will be passively waited until the duration of the stretching exercise program (approximately 4-5 min). Afterwards, second evaluation will be performed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Shoulder internal rotation range of motion	Change of shoulder internal rotation range of motion (with bubble inclinometer)	Baseline and just after stretching exercise

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Posterior shoulder tightness	Change of posterior shoulder tightness (with bubble inclinometer)	Baseline and just after stretching exercise
Concentric strength	Change of trapezius muscles, rotattor cuff muscles concentric strength (in kg, with hand held dynamometer)	Baseline and just after stretching exercise
Eccentric strength	Change of shoulder abduction and external rotation eccentric strength (in kg, with hand held dynamometer)	Baseline and just after stretching exercise
Subacromial space	Change of subacromial space ( with Ultrasound)	Baseline and just after stretching exercise
Pain	Change of visual analog scale score in activity and rest	Baseline and just after stretching exercise
Shoulder external rotation range of motion	Change of shoulder external rotation range of motion (with bubble inclinometer)	Baseline and just after stretching exercise

Collaborators and Investigators

• Sponsor: Dokuz Eylul University
• Investigators: Study Director: Damla GULPINAR, MS, Izmir Katip Celebi University

Study record dates

Study Major Dates

• Study Start (ACTUAL): August 28, 2017
• Primary Completion (ACTUAL): December 15, 2019
• Study Completion (ACTUAL): January 2, 2020

Study Registration Dates

• First Submitted: August 8, 2017
• First Submitted That Met QC Criteria: August 8, 2017
• First Posted (ACTUAL): August 11, 2017

Study Record Updates

• Last Update Posted (ACTUAL): February 21, 2020
• Last Update Submitted That Met QC Criteria: February 20, 2020
• Last Verified: February 1, 2020

More Information

Terms related to this study

• Keywords: static stretching; isolytic stretching; Glenohumeral Internal Rotation Deficit
• 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: 3418-GOA

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No