Pragmatic Set of Interventions Versus Scapular Strengthening Exercises on Scapular Dyskinesia in Adhesive Capsulitis

October 30, 2023 updated by: Riphah International University

Effects of Pragmatic Set of Interventions Versus Scapular Strengthening Exercises on Scapular Dyskinesia in Adhesive Capsulitis

The aim of this study is to determine the Effects of pragmatic set of interventions versus scapular strengthening exercises on scapular dyskinesia in adhesive capsulitis.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Scapular dyskinesia (SD) is a term that describes a physical impairment in which the scapula's position and motion are altered.Symptoms of SD can be one or a combination of the anterior shoulder pain, Postero-superior scapular pain, superior shoulder pain, proximal lateral arm pain. scapular dyskinesia is commonly found in adhesive capsulitis patients. To determine the scapular dyskinesia with shoulder pain two tests that apply manual assistance to the scapula are lateral scapular slide test and wall push up test.

Pragmatic set of interventions are an important element in rehabilitation, and has improved the treatment of many musculoskeletal and neurological conditions. Scapular strengthening exercises, which aims to improve abnormal scapular movements that commonly occur in people with adhesive capsulitis.

The purpose of this study is to explore the effect of scapular focused exercises on the rehabilitation of adhesive capsulitis, patient with scapular dyskinesia. The importance of scapular rehabilitation in the treatment of scapular dyskinesia and to examine the comparative effect of pragmatic set of intervention with scapular strengthening protocol on scapular dyskinesia.

My study on the effect of a pragmatic set of intervention versus scapular strengthening exercises on scapular dyskinesia in adhesive capsulitis is important because it addresses a gap in the current literature. While both interventions have been shown to improve scapular dyskinesia in patients with adhesive capsulitis, there is a lack of studies comparing the two methods. My study will help determine which intervention is more effective in treating scapular dyskinesia, which will be valuable information for healthcare providers working with patients with adhesive capsulitis

Study Type

Interventional

Enrollment (Estimated)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan, 54000
        • Recruiting
        • Amina welfare and Trust
        • Contact:
        • Principal Investigator:
          • Amna Shahzade, MSOMPT

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Both male and females with age range b/w 25-45
  • People with adhesive capsulitis (having pain, stiffness, and decrease movements of - external rotation, forward flexion and abduction)
  • Scapular dyskinesia (positive lateral scapular slide with difference of 1.5cm when measurements are compared bilaterally)

Exclusion Criteria:

  • History of shoulder surgery or other significant shoulder injury, neurological or musculoskeletal conditions that may affect shoulder function.
  • History of significant medical conditions (e.g., heart disease, cancer) that may affect their ability to participate in the study.
  • Pregnant or breast feeder, as the exercise program may not be safe or appropriate for them.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: pragmatic set of interventions

The pragmatic set included 6 interventions as follows.

  1. Pragmatic posterior capsular stretch (PPCS)
  2. Serratus anterior stretch (SAS)
  3. Rotator cuff facilitation (RCF)
  4. Acromioclavicular joint mobilization
  5. Pectoralis minor stretch
  6. Thoracic manipulation
Other: pragmatic set of interventipons

The pragmatic set included 6 interventions as follows.

  1. Pragmatic posterior capsular stretch (PPCS)
  2. Serratus anterior stretch (SAS)
  3. Rotator cuff facilitation (RCF)
  4. Acromioclavicular joint mobilization.
  5. Pectoralis minor stretch
  6. Thoracic manipulation Five to ten sweeps per minute are administered three to four times. The applied force is combined with deep breathing. The subject is asked to report discomfort and the applied force is adjusted.
Placebo Comparator: scapular strengthening exercises

Scapular strengthening exercises will be individualised focusing on Serratus anterior, trapezius, Levator scapulae, Rhomboids.

Serratus anterior;

  • Dynamic hug
  • Scaption with external rotation
  • Diagonal PNF (shoulder flexion, horizontal flexion, external rotation),

Trapezius - Upper trapezius:

  • Unilateral shoulder shrug,
  • Rowing,
  • Forward shoulder flexion,
  • Shoulder abduction in scapular plane above 120 degrees.

Middle trapezius:

  • Prone shoulder horizontal abduction
  • Scaption, horizontal abduction with external rotation

Lower trapezius:

  • Unilateral scapular retraction,
  • Prone bilateral shoulder external rotation at 90 degrees of abduction,
  • Prone shoulder abduction.

Levator Scapulae:

  • Horizontal abduction with shrug,
  • Horizontal abduction with ER,
  • Prone shoulder extension.

Rhomboids:

  • ER at 90° of abduction,
  • ER at 0° of abduction,
  • Horizontal abduction,
  • Shoulder extension,
Other: scapular strengthening exercise.
• Subjects in Group B receive strengthening exercises (exercise will perform with 15 repetitions for each set- 3sets/day, 3 days /week for 6 weeks. In Scapular strengthening exercises, treatment protocol will involve the individualized for focus muscle Serratus anterior (Dynamic hug, Scaption with external rotation, Diagonal PNF (shoulder flexion horizontal flexion, external rotation),Trapezius - Upper trapezius (unilateral shoulder shrug, rowing, forward shoulder flexion, shoulder abduction in scapular plane above 120 degrees, Middle trapezius (prone shoulder horizontal abduction, scaption, horizontal abduction with external rotation), Lower trapezius (Unilateral scapular retraction, prone bilateral shoulder external rotation at 90 degrees of abduction, prone shoulder abduction), Levator Scapulae (horizontal abduction with shrug, horizontal abduction with ER, prone shoulder extension, Rhomboids (ER at 90° of abduction, ER at 0° of abduction, Horizontal abduction, Shoulder extension)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The Shoulder Pain and Disability Index (SPADI)
Time Frame: 4th week
The Shoulder Pain and Disability Index (SPADI) was developed to measure current shoulder pain and disability in an outpatient setting. The SPADI contains 13 items that assess two domains; a 5-item subscale that measures pain and an 8-item subscale that measures disability. SPADI was found to have reliability coefficients of ICC ≥ 0.89 in a variety of patient populations.Internal consistency is high with Cronbach α typically exceeding 0.90. The SPADI demonstrates good construct validity, correlating well with other region-specific shoulder questionnaires.
4th week
Scapulometer
Time Frame: 4th week
is a reliable tool to measure scapular medial border and inferior angle prominence. It is used to measure the distance from the root of the spine (ROS) and the inferior angle (INF) of the scapula to the thorax wall. The novel scapulometer has excellent reliability and fair validity to quantify medial border and inferior angle prominence of the scapula. Further research utilizing this instrument is recommended.
4th week

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual analogue scale:
Time Frame: 4th week
This VAS will be used in this study to measure Pain. Patients were instructed to assess the severity of shoulder pain experienced last week on a 0-10 cm horizontal line (0 = painless and 10 = worst pain imaginable). The VAS has been shown to have excellent test-retest reliability (ICC = 0.97) and high validity (r with a 5-point verbal descriptive scale = 0.71-0.78) to evaluate pain perception.
4th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Rabiya Noor, PhD, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 8, 2023

Primary Completion (Estimated)

December 8, 2023

Study Completion (Estimated)

January 8, 2024

Study Registration Dates

First Submitted

October 25, 2023

First Submitted That Met QC Criteria

October 30, 2023

First Posted (Actual)

October 31, 2023

Study Record Updates

Last Update Posted (Actual)

October 31, 2023

Last Update Submitted That Met QC Criteria

October 30, 2023

Last Verified

October 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR & AHS/23/0150

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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