The Effect of Biomechanical Scapular Mobilization With Movement and Motor Learning (BSMWM)

The Effect of Biomechanical Scapular Mobilization With Movement and Motor Learning in Shoulder Impingement Patients

the study about new mobilization technique used in shoulder impingement syndrome patient to increase the range of motion of elevation, decrease the pain, and increasing the function level, this technique is based on normal mechanics that occur inside the joint during certain movement.

Study Overview

• Status: Completed
• Conditions: Shoulder Impingement Syndrome
• Intervention / Treatment: Other: biomechanical scapular mobilization with movement and motor learning

Detailed Description

The study is about a new technique of mobilization based on normal biomechanics that occurs during the movements of a joint. For example, shoulder abduction or elevation needs the scapula to move upward rotation with posterior tilt and external rotation. Moreover, needs glenohumeral (GH) joint glide inferior and posterior these movements occur normally to permit us to elevate our shoulder without any restriction and the full range of motion(ROM). so in the patients with shoulder problems and have difficulties reaching full ROM of elevation the investigators applied mobilization of scapula toward upward rotation with external rotation and posterior tilt and by using mobilization belt applied posterior and inferior glide to GH joint. However, mobilization techniques have a short-term effect to enhance this effect, the investigators adding a motor learning approach to achieve a long-term effect and prevent recurrent .the investigators applied this technique 3 times per week for 3 weeks.

• Study Type: Interventional
• Enrollment (Actual): 38
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Alexandria, Egypt
    • Pharos University in Alexandria

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 25 years to 50 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

clinical diagnosis: shoulder impingement syndrome.

1. History of shoulder pain when they elevated their arm.
2. Limited range of motion due to the pain.
3. Pain localized at the painful point at proximal anterolateral shoulder region or medical diagnosis of shoulder impingement syndrome with at least 2 positive impingement tests including Neer, Hawkins, or Jobe test.

Exclusion Criteria:

• Fibromyalgia.
• Fracture, dislocation, or subluxation of the shoulder.
• history of trauma.
• shoulder surgery.
• numbness or tingling in the upper limb.
• Corticosteroids injection within 1 year.
• systemic illness.
• ligamentous laxity

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
ACTIVE_COMPARATOR: group A (controlled group); received passive range of motion (PROM)/ active assisted range of motion (AAROM)/ active range of motion (AROM) exercises, strengthen of rotator cuff, biceps, shoulder and scapular muscles, ultrasound (5 min. - 1.5 W/c.m2 - 1 MHZ), electrical stimulation ( interferential bipolar technique for 20 min. on shoulder joint). This treatment was repeated three times per weeks with 24 hours rest for 3 weeks.	Other: biomechanical scapular mobilization with movement and motor learning; the therapist applied posterior tilt and exteral rotation with upward rotation mobilization to scapula and therapist also warp bilt around GH joint to applied inferior and posterior glid then ask patient to elevate his arm. then we applied motor learning approach by asking patient to elevate his arm with maintaining of external rotation with posterior glid of scapula.
ACTIVE_COMPARATOR: group B(Study group); All patients in group B received biomechanical scapular mobilization with movement and motor learning and traditional methods.	Other: biomechanical scapular mobilization with movement and motor learning; the therapist applied posterior tilt and exteral rotation with upward rotation mobilization to scapula and therapist also warp bilt around GH joint to applied inferior and posterior glid then ask patient to elevate his arm. then we applied motor learning approach by asking patient to elevate his arm with maintaining of external rotation with posterior glid of scapula.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analogue Scale	1. Visual Analogue Scale: was used to evaluate the intensity of pain, which The pain VAS is a continuous scale comprised of a horizontal (HVAS) or vertical (VVAS) line, usually, 10 centimetres in length, anchored by 2 verbal descriptors, one for each symptom extreme. For pain intensity, the scale is most commonly anchored by "no pain" (score of 0) and "pain as bad as it could be" or "worst imaginable pain" (score of 10 centimetres).	3 weeks
Universal Goniometer	Universal goniometer: was used to measure the available range of motion at a joint. where used to measure an available range of motion of abduction and flexion of the shoulder joint.	3 weeks

Collaborators and Investigators

• Sponsor: Pharos University in Alexandria
• Investigators: Study Chair: Moataz A. Mohamed, (B.Sc.P.T.), Pharos University in Alexandria

Publications and helpful links

General Publications

• Surenkok O, Aytar A, Baltaci G. Acute effects of scapular mobilization in shoulder dysfunction: a double-blind randomized placebo-controlled trial. J Sport Rehabil. 2009 Nov;18(4):493-501. doi: 10.1123/jsr.18.4.493.

Study record dates

Study Major Dates

• Study Start (ACTUAL): May 5, 2021
• Primary Completion (ACTUAL): October 22, 2021
• Study Completion (ACTUAL): November 14, 2021

Study Registration Dates

• First Submitted: January 5, 2021
• First Submitted That Met QC Criteria: January 7, 2021
• First Posted (ACTUAL): January 8, 2021

Study Record Updates

• Last Update Posted (ACTUAL): May 18, 2022
• Last Update Submitted That Met QC Criteria: April 29, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Shoulder Impingement Syndrome
• Other Study ID Numbers: PUA 201901013

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Study Data/Documents

1. Book
   Information comments: Neumann, D. D. (2010). kinesology of musculoskeletal system. In Mosby, Inc., an affiliate of Elsevier Inc. The book described normal biomechanics of the shoulder during the elevation.
2. Book
   Information comments: the posterior glid and inferior glid of GH joint is increasing the range of motion and decreasing the pain
3. Clinical Study Report
   Information comments: the effect of mobilization in increasing range of motion and decreasing of pain

Drug and device information, study documents

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