Scapular ms Strength vs PNF in SIS Patients

Scapular Muscle Strengthening Versus Scapular Proprioceptive Neuromuscular Facilitation In Shoulder Impingement Syndrome

HYPOTHESES:

1. There will be no significant difference between scapular muscle strengthening and PNF exercise on improving muscle strength of upper trapezius in patients with shoulder impingement syndrome.
2. There will be no significant difference between scapular muscle strengthening and PNF exercise on improving muscle strength of middle trapezius in patients with shoulder impingement syndrome.
3. There will be no significant difference between scapular muscle strengthening and PNF exercise on improving muscle strength of lower trapezius in patients with shoulder impingement syndrome.
4. There will be no significant difference between scapular muscle strengthening and PNF exercise on improving muscle strength of serratus anterior in patients with shoulder impingement syndrome.
5. There will be no significant difference between scapular muscle strengthening and PNF exercise on muscle ratio of upper trapezius/lower trapezius muscles in patients with shoulder impingement syndrome.
6. There will be no significant difference between scapular muscle strengthening and PNF exercise on muscle ratio of upper trapezius/middle trapezius muscles in patients with shoulder impingement syndrome.
7. There will be no significant difference between scapular muscle strengthening and PNF exercise on muscle ratio of upper trapezius/serratus anterior muscles in patients with shoulder impingement syndrome.
8. There will be no significant difference between scapular muscle strengthening and PNF exercise on scapular symmetry at 0⁰ abduction in patients with shoulder impingement syndrome.
9. There will be no significant difference between scapular muscle strengthening and motor control exercise on scapular symmetry at 45⁰ abduction in patients with shoulder impingement syndrome.
10. There will be no significant difference between Scapular muscle strengthening and motor control exercise on scapular symmetry at 90⁰ abduction in patients with shoulder impingement syndrome.
11. There will be no significant difference between scapular muscle strengthening and PNF exercise on improving pain in patients with shoulder impingement syndrome.
12. There will be no significant difference between scapular muscle strengthening and PNF exercise on improving function in patients with shoulder impingement syndrome.

Study Overview

• Status: Suspended
• Conditions: Shoulder Impingement
• Intervention / Treatment: Other: exercises

Detailed Description

Sub-acromial Impingement Syndrome (SIS) has been identified with a prevalence of almost 40% among shoulder pathologies. SIS has significant economic consequences owing to its treatment costs and losses incurred through workplace absenteeism.

Alterations in scapular muscle performance have been found in subjects with scapular dyskinesis. Hyperactivity of the upper trapezius (UT) with reduced middle (MT) and lower trapezius (LT) muscle activation in addition to insufficient serratus anterior (SA) muscle function have been related to decreased amounts of scapular upward rotation, external rotation, and posterior tilt in patients .

Research into scapular stability exercises for the management of SIS is increasing, yet there is little evidence on their efficacy .

The addition of scapular stabilization exercises to stretching and strengthening exercises can be significantly beneficial in increasing the strength, developing joint position sense and decreasing dyskinesia.

Proprioceptive neuromuscular facilitation (PNF) is a rehabilitation concept which is widely used by physical therapists , promoting motor learning, motor control, strength and mobility . This comprehensive rehabilitation approach includes task-oriented training with manual facilitation aimed at motor learning and motor control .

To the authors' knowledge, none of the studies has investigated the potential effect abnormal scapular muscle strengthening versus PNF exercise on the muscle strenth, muscle ratio, and ROM of the scapula during arm elevation in patient with SIS.

• Study Type: Interventional
• Enrollment (Anticipated): 66
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Giza, Egypt
    • Cairo university

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 50 years (ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• • age of 20-50 years.

  • body mass index (BMI)<20 kg/m2
  • subjects complaining Shoulder impingement.
  • subjects with altered scapular resting positions and dyskinesis (
  • Subjects will be included if they met at least 2 of the following 5 criteria: Neer's Impingement Test, Hawkins-Kennedy Impingement Test, Supraspinatus ("Empty Can" or Jobe) Test, Apprehension and relocation Tests

Exclusion Criteria:

• Undergone shoulder surgery.
• exhibited symptoms related to the cervical spine.
• taking nonsteroidal anti-inflammatory medications.
• received a steroid injection in the past 12 months.
• were already enrolled in a physical therapy program.

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: scapular muscle strengthening exercises; Group A (n=22): will receive a program of scapular muscle strengthening exercises for 18 sessions (3 sessions per week for six weeks)	Other: exercises; scapular exercise
EXPERIMENTAL: PNF exercise; Group B (n=22): will receive a scapular PNF exercise program for the same frequency as in group A	Other: exercises; scapular exercise
NO_INTERVENTION: control; Group C (n=22): will be a control group who will not receive any treatment during the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
muscle strength for scapular muscles by Lafayette hand held dynamometer	muscle strength of upper trapezius,middle trapezius ,lower trapezius and serratus anterior in patients with shoulder impingement syndrome. pre and post application of between scapular muscle strengthening and PNF exercise	baseline
muscle ratio by dividing muscle strength of each muscle on the other	muscle ratio of upper trapezius/lower trapezius,upper trapezius/middle trapezius and upper trapezius/serratus anterior muscles in patients with shoulder impingement syndrome. pre and post application of between scapular muscle strengthening and PNF exercise	baseline
muscle angle by lateral scapular slide test	scapular symmetry at 0⁰ abduction ,45⁰ abduction and 90⁰ abduction in patients with shoulder impingement syndrome pre and post application of between scapular muscle strengthening and PNF exercise	baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pain improvement by shoulder pain and disability index.	improving pain in patients with shoulder impingement syndrome.	baseline
function improvment by shoulder pain and disability index.	improving function in patients with shoulder impingement syndrome pre and post application of between scapular muscle strengthening and PNF exercise	baseline

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Study Director: mohamed AH ABDELMEGEED, lecturer, Cairo university; Study Chair: salwa fadl, PROFESSOR, Cairo university

Publications and helpful links

General Publications

• Aceituno-Gomez J, Garcia-Madero VM, Blazquez-Gamallo R, Harto-Martinez AM, Mohedano A, Vinuela A, Avendano-Coy J, Gomez-Soriano J, Munoz-Gonzalez A, Gonzalez-Gonzalez J, Criado-Alvarez JJ. [Health-related quality of life in patients diagnosed with subacromial syndrome in the Talavera Integrated Area]. Rev Esp Salud Publica. 2019 Oct 17;93:e201910094. Spanish.

Study record dates

Study Major Dates

• Study Start (ANTICIPATED): September 12, 2022
• Primary Completion (ANTICIPATED): April 12, 2023
• Study Completion (ANTICIPATED): April 12, 2023

Study Registration Dates

• First Submitted: August 29, 2022
• First Submitted That Met QC Criteria: September 6, 2022
• First Posted (ACTUAL): September 10, 2022

Study Record Updates

• Last Update Posted (ACTUAL): September 10, 2022
• Last Update Submitted That Met QC Criteria: September 6, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Keywords: pnf
• Additional Relevant MeSH Terms: Wounds and Injuries; Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Shoulder Impingement Syndrome
• Other Study ID Numbers: MS strength VS PNF IN SIS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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