Effects of Scapular Therapeutic Exercise on Essential Biomechanical and Neurophysiological Parameters in Shoulder Pain Conditions With Scapular Impairments

Shoulder pain is a prevalent and recurrent condition. After a period of shoulder pain, some adaptations could be found, as in scapular muscles and kinematics and/or in nervous system.

It seems important to assess several biomechanical and neurophysiological outcomes to better characterize shoulder pain conditions and to program an intervention plane.

Therapeutic exercise is one of the treatments used for shoulder pain, however there are still doubts and controversial findings regarding exercise focusing the scapular musculature. Thus, the present study aims to assess the effects of an intervention protocol based on scapular therapeutic exercise.

Study Overview

• Status: Completed
• Conditions: Shoulder Pain
• Intervention / Treatment: Other: Experimental Scapular Therapeutic Exercise Group

Detailed Description

The study only started after approval of the protocol

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Portugal
  • Porto, Portugal, 4200 - 072
    • Center for Rehabilitation Research, School of Health, Polytechnic of Porto

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 18 to 65 years old
• Chronic (more than 3 months), continuously or intermittently, non-specific or associated with a diagnostic (except if mentioned in the exclusion criteria) shoulder pain of, at least, moderate intensity
• Presenting scapular alterations as scapular dyskinesis (identified at rest or during motion)

Exclusion Criteria:

• History of shoulder fracture, dislocation, tears, infection or neoplasm
• Shoulder surgery
• Cervical and/or thoracic pathologies or pain associated with active movements of these regions
• Neurological disease
• Body mass index out of the range 18,5-30 kg/m2 and muscular skinfold higher than 20mm
• Inability to perform the exercises
• Current practice of competitive/high-level exercise/sport focusing the upper limb

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental Scapular Therapeutic Exercise Group; Patients in this group will perform therapeutic exercises, recommended for subjects with shoulder pain and focusing the neuromuscular control, stretching and/or strengthening of the scapular muscles	Other: Experimental Scapular Therapeutic Exercise Group; All subjects will perform a program of scapular therapeutic exercises including: neuromuscular control/strength - scapular therapeutic exercises that leads to, at least, moderate muscular activity levels; and stretching exercises. The intervention period will be of 8 weeks, considering in-person and/or home sessions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in shoulder pain	The intensity of pain will be measured with a self-reported 11-point scale (Numerical Rating Pain Scale), with scores ranging from 0 (no pain) to 10 (maximum pain)	Baseline and one week after intervention
Change in shoulder function	Shoulder functional status will be measured with a self-reported 13 items scale (SPADI), which ranges from 0 (fully functional) to 100 (maximum degree of disability).	Baseline and one week after intervention
Change in scapular muscles activity levels	Scapular muscles activity levels, during shoulder analytical movements and during a functional task, will be recorded superficially by a wireless electromyographic signal detector system	Baseline and one week after intervention
Change in scapular muscles ratio	Ratio between scapular muscles activity levels, during shoulder analytical movements and during a functional task, will be calculated considered the superficially eletromyographic data measured by a wireless electromyographic signal detector system.	Baseline and one week after intervention
Change in kinematics	Scapular kinematics and scapulohumeral rhythm, during shoulder analytical movements and during a functional task, will be measured by inertial sensors and described in degrees (°)	Baseline and one week after intervention
Change in movement quality through time variables	Movement quality will be assessed considering time to peak acceleration and task completion time, calculated according to the data recorded with inertial sensors	Baseline and one week after intervention
Change in movement quality through trunk compensation	Movement quality will be also assessed considering the trunk motion, calculated according to the data recorded with inertial sensors	Baseline and one week after intervention
Change in movement quality through smoothness	Smoothness will be calculated by jerk logarithm of data recorded with inertial sensors	Baseline and one week after intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in muscle stiffness	Scapular muscles stiffness will be assessed by myotonometry (using a digital palpation device)	Baseline and one week after intervention
Change in pressure pain threshold	An assessment point in the shoulder area will be assessed by the application of a mechanical pressure by an algometer	Baseline and one week after intervention
Change in pain-related fear	Assessed with self-reported scales - Tampa Scale for Kinesiophobia, which ranges from 13 (best) to 52 (worst)	Baseline and one week after intervention
Change in pain catastrophization	Assessed with a self-reported scale - Pain Catastrophizing Scale, which ranges from 0 (better) to 52 (worst)	Baseline and one week after intervention
Self-impression of change	The patient's individual perspective about his/her condition and changes felt considering the intervention received will be assessed by a self-reported scale - Patient global impression of change scale, which range from 0 [no change (or condition has got worse)] to 7 (a great deal better, and a considerable improvement that has made all the difference)	One week after intervention

Collaborators and Investigators

• Sponsor: Polytechnic Institute of Porto
• Collaborators: Universidade do Porto; School of Health of Polytechnic Institute of Porto; Center for Rehabilitation Research - Human Movement System (Re)habilitation Area; Porto Biomechanics Laboratory; Center for Interdisciplinary Applied Research in Health, Health School of the Setubal, Polytechnic Institute
• Investigators: Principal Investigator: Ana Melo, Polytechnic Institute of Porto

Study record dates

Study Major Dates

• Study Start (Actual): April 20, 2023
• Primary Completion (Actual): August 31, 2023
• Study Completion (Actual): August 31, 2023

Study Registration Dates

• First Submitted: March 17, 2023
• First Submitted That Met QC Criteria: April 3, 2023
• First Posted (Actual): April 18, 2023

Study Record Updates

• Last Update Posted (Actual): July 30, 2024
• Last Update Submitted That Met QC Criteria: July 28, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: Shoulder pain; Therapeutic exercise; Scapular kinematics; Scapular muscles
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Joint Diseases; Musculoskeletal Diseases; Arthralgia; Shoulder Pain
• Other Study ID Numbers: CE0108C; UIDB/05210/2020 (Other Grant/Funding Number: Fundação para a Ciência e Tecnologia, Portugal and EU); SFRH/BD/140874/2018 (Other Grant/Funding Number: Fundação para a Ciência e Tecnologia (FCT), Portugal)

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