Comparison of Scapular Stabilization and Mobilizations in Sub Acromial Pain Syndrome

Comparison of Scapular Stabilization Exercises and Scapular Mobilizations in Patients With Sub Acromial Pain Syndrome

The aim of this research is to compare the effect Comparison of scapular stabilization exercises and scapular mobilizations on shoulder pain, scapular kinematics, disability and functional limitations in patients with sub acromial pain syndrome Randomized controlled trials done at District Head Quarters Mirpur AJK. The sample size was 36. The subjects were divided in two groups, 18 subjects in scapular mobilization exercise group and 18 in scapular mobilization exercise therapy group. Study duration was of 12 months. Sampling technique applied was non probability convenient sampling technique. Only 25-40 years old patient with unilateral shoulder pain lasting >6 weeks were included. Tools used in the study are NPRS, SPADI, WORC LSST and SAT.

Study Overview

• Status: Completed
• Conditions: Subacromial Impingement Syndrome
• Intervention / Treatment: Other: Experimental interventional group 1(scapular stabilization exercise therapy); Other: Experimental :interventional group II (scapular mobilizations)

Detailed Description

Sub acromial pain syndrome (SAPS), an up to date terminology (shoulder impingement syndrome ) is a common healthcare problem, especially in adult where the space directly below the acromion process and above the shoulder joint, has narrowed and patients describe pain on lateral and anterior aspect of shoulder . The estimated prevalence in the general population is 7 to 26 percent and it accounts for 44 to 65% of all shoulder problems. Incidence of shoulder impingement in the US military population is 7.77 cases/1000 person-years and in UK 3 out of every 4 patient with shoulder pathologies are seeking medical treatment for SAPS. Risk factors include repetitive activity above the shoulder, decubitus sleeping position, a hook-type acromion, smoking, muscle imbalance, bone and joint abnormalities etc. Common symptoms are persistent pain without any history of trauma, difficulty reaching up behind the back, weakness in shoulder muscles, pain when the arm is raised between 70 and 120 degrees and scapular dyskinesia.

• Research surrounding sub acromial pain syndrome has experienced significant growth recently especially in the area of its management. Physiotherapy management protocol for SAPS includes, postural correction exercises, neuromuscular control exercises, Stretching's, manual therapy techniques of the shoulder, scapular stabilization and Mobility Exercises and myofacial release therapy. Scapular stabilization exercises based on open and closed kinetic chain exercises to increase muscle strength and joint position awareness.

• Study Type: Interventional
• Enrollment (Actual): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Azad Jammu Kashmir
    • Mirpur, Azad Jammu Kashmir, Pakistan, 10250
      • District Head Quarters

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• ● Unilateral shoulder pain lasting >6 weeks

  • Patients with 3/5 positive special tests (Hawkins-Kennedy test, painful arc test, Neer test, Job test, resisted external rotation test)
  • Patients score falling above 3 on NPRS

Exclusion Criteria:

• • History of surgery, fracture, or dislocation in past 6 months

  • Traumatic onset of pain.
  • received steroid injections and physical therapy during the previous 6 months
  • BMI above 30

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental interventional group 1(scapular stabilization exercise therapy); 1. Ball stabilization exercise, 2.Wall push up 3. Wall push up Patients will be treated 3 times per week for 4 consecutive weeks	Other: Experimental interventional group 1(scapular stabilization exercise therapy); Ball stabilization exercise: While standing close to the wall, the participant will be asked to position her affected hand on the ball and keep the ball from moving as disturbance will be applied in different directions. Wall push up: While facing wall patient will be asked to place both hands on wall, shoulder width apart. He will be instruct to breath in, bend his elbows, lean into wall and hold this position for one second then breath out slowly push back until arms are straight again Wall slides • Patient will be asked to lean his head, upper thorax and butts against the wall, place his hands and arms against the wall in high five position.
Experimental: Experimental :interventional group II (scapular mobilizations); scapular mobilization in elevation, depression, protraction and retraction. Patients will be treated 3 times per week for 4 consecutive weeks	Other: Experimental :interventional group II (scapular mobilizations); Patient lies on unaffected side close to the edge of the treatment bench with hips and knees bent for stability. Therapist will start by supporting the patient arm on his/her forearm so that shoulder is in maximally loose pack position. Then he/she will grab on the scapula with both hands. One hand supports the scapula from cranial around the acromion and scapular spine and other hand from the caudal at the inferior angle of scapula. Then both hands move the scapula cranially over the thorax into elevation and caudally into the depression, upward/downward rotation as well as retraction and protraction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Western Ontario Rotator Cuff Index (WORC)	It has 21 items, exploring 5 different domains: Physical symptoms, Sports and recreation, Work, Social function, Emotions. Each question uses a visual analogue scale (VAS) - which is a straight line, representing a 100-point scale, ranging from 0-100.	baseline to 4 weeks
Lateral Scapular Slide Test (LSST)	this test measures the distance between inferior angle of scapula and nearest vertebral spinous process using tape or goniometer in neutral, 45 and 90 degrees of shoulder abduction with the arms fully internally rotated	baseline to 4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Shoulder Pain and Disability Index (SPADI)	SPADI measures pain and disability related to shoulder pain and It has 13 items with response options ranging from 0(no pain) to 10 (worst pain), the overall score ranges from 0 to 100.	baseline to 4 weeks
Numeric pain rating scale	This is an 11 point outcome measure used to measure intensity of pain ranging from 0 (no pain) to 10 (worst imaginable pain)	baseline to 4 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Aisha Razzaq, PHD*, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): April 15, 2024
• Primary Completion (Actual): June 30, 2024
• Study Completion (Actual): July 31, 2024

Study Registration Dates

• First Submitted: May 19, 2024
• First Submitted That Met QC Criteria: May 19, 2024
• First Posted (Actual): May 23, 2024

Study Record Updates

• Last Update Posted (Estimated): November 13, 2024
• Last Update Submitted That Met QC Criteria: November 12, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: Range of motion; Scapular stabilization exercises; scapular mobilization
• Additional Relevant MeSH Terms: Shoulder Injuries; Musculoskeletal Diseases; Wounds and Injuries; Pathologic Processes; Joint Diseases; Disease; Syndrome; Shoulder Impingement Syndrome
• Other Study ID Numbers: MSPT/01723 Gulban Aslam

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