Comparison Of The Effects Of Conventional Physiotherapy And Strengthening Exercises With Rotator Cuff Syndrome

Comparison Of The Effects Of Conventional Physiotherapy And Strengthening Exercises Additional To Conventional Physiotherapy On Pain, Muscle Strength, Joint Range Of Motion, Functionality And Quality Of Life In Patients With Rotator Cuff Syndrome

Various options are available for the treatment of rotator cuff syndrome, including conservative and surgical. Conservative treatment methods include activity modification, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections (CSIs), and physiotherapy. Physiotherapy methods include various interventions such as manual therapy, exercise, and electrotherapy. Although these treatments do not directly treat the specific pathology, they help correct rotator cuff and scapular muscle weakness and dysfunction, reduce the tightness of the posterior capsule and other soft tissues, and relieve pain and dysfunction. It focuses on correcting the postural abnormalities that contribute to the disease.

In our study, the investigators aimed to determine the effects of rehabilitation components in the conservative treatment of patients with rotator cuff syndrome and to determine the effects of strengthening exercises on the functional status of the patients.

Study Overview

• Status: Completed
• Conditions: Physiotherapy; Rotator Cuff Syndrome
• Intervention / Treatment: Other: Exercise

Detailed Description

Rotator cuff syndrome (RCS), also known as rotator cuff tendonitis, is characterised by intense pain, functional impairment, loss of shoulder range of motion (ROM), nocturnal pain, and limitations in activities of daily living. It is a common problem in the ageing population and its patophysiology may be the result of tendon degeneration resulting from microtrauma (repetitive activities, overload) or traumatic injury.

Groups Participants were randomly divided into two treatment groups. There are 10 patients in each group. The patients in the control group received a standard treatment programme, while the patients in the experimental group received strengthening exercises with theraband in addition to the standard treatment programme. Treatment sessions for both groups lasted 50-55 minutes and were performed three days a week. Details of the study groups are given below.

Control Group

Patients in the control group received a standard treatment programme. This programme included the following:

Passive stretching exercises were performed 10 repetitions for each movement (shoulder flexion, abduction, adduction, internal rotation, external rotation). Codman exercises were performed 15 repetitions (with 1kg dumbbell). Shoulder isometric exercises were performed 15 repetitions for each movement (ball press, clockwise and anti-clockwise ball rotation, finger slide on the wall). Wand exercises were performed 15 repetitions (shoulder abduction, internal rotation, external rotation). Electrotherapy was applied for 20 minutes and ice therapy was applied for 20 minutes.7-9 Experimental Group

Patients in the experimental group received strengthening exercises with theraband in addition to the standard treatment programme. This programme included the following:

Strengthening Exercises: Low-row, biceps strengthening, shoulder horizontal abduction and shoulder horizontal adduction, external rotation. After the pain decreased, strengthening exercises for subscapularis, infraspinatus, supraspinatus, teres minor, deltoid and scapulothoracic muscles were performed. The colour of the Theraband was chosen between yellow, red, green, blue and red to the extent tolerated by the patient.

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

Contacts and Locations

Study Locations

• Turkey
  • Küçükçekmece
    • Istanbul, Küçükçekmece, Turkey, 34303
      • Physical Therapy and Rehabilitation Clinic of Istanbul Health Sciences University Kanuni Sultan Süleyman Training and Research Hospital

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• having complaints for at least three months
• having positive Empty can test
• having rotator cuff injury
• having loss of function in the shoulder and volunteering to participate in the study

Exclusion Criteria:

• cardiovascular disease that would interfere with the rehabilitation process,
• who had neurological or systemic musculoskeletal disease
• who had undergone upper extremity surgery
• who had upper extremity scapula fracture

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Rotator Cuff Patients with used to conventional rehabilitation; Patients in the experimental group received strengthening exercises with theraband in addition to the standard treatment programme. This programme included the following: Strengthening Exercises: Low-row, biceps strengthening, shoulder horizontal abduction and shoulder horizontal adduction, external rotation. After the pain decreased, strengthening exercises for subscapularis, infraspinatus, supraspinatus, teres minor, deltoid and scapulothoracic muscles were performed. The colour of the Theraband was chosen between yellow, red, green, blue and red to the extent tolerated by the patient.	Other: Exercise; Participants were randomly divided into two treatment groups. There are 10 patients in each group. The patients in the control group received a standard treatment programme, while the patients in the experimental group received strengthening exercises with theraband in addition to the standard treatment programme. Treatment sessions for both groups lasted 50-55 minutes and were performed three days a week. Details of the study groups are given below.
Experimental: Rotator Cuff Patients with used to conventional rehabilitation add to strenght exercise.; Patients in the experimental group received strengthening exercises with theraband in addition to the standard treatment programme. This programme included the following: Strengthening Exercises: Low-row, biceps strengthening, shoulder horizontal abduction and shoulder horizontal adduction, external rotation. After the pain decreased, strengthening exercises for subscapularis, infraspinatus, supraspinatus, teres minor, deltoid and scapulothoracic muscles were performed. The colour of the Theraband was chosen between yellow, red, green, blue and red to the extent tolerated by the patient.	Other: Exercise; Participants were randomly divided into two treatment groups. There are 10 patients in each group. The patients in the control group received a standard treatment programme, while the patients in the experimental group received strengthening exercises with theraband in addition to the standard treatment programme. Treatment sessions for both groups lasted 50-55 minutes and were performed three days a week. Details of the study groups are given below.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Disability Questionnaire for Arm, Shoulder and Hand (Quick DASH):	Quick DASH was used as the primary outcome measure because it is a questionnaire that assesses upper extremity injuries and symptoms and measures their impact on patients' activities of daily living. Each section of the Quick-DASH questionnaire yields a score between 0 and 100 (0= no disability, 100= maximum disability).10,11	3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Western Ontario Rotator Cuff Index (WORC)	WORC was used to assess the impact of rotator cuff problems on quality of life.(Kirkley Alvarez) Each question is answered with a 100mm VAS. The total is between 0 and 2100, with lower scores indicating higher quality of life.	1 months
Nothingam Health Profile (NSP):	The NSP was used to measure the general health status and quality of life of the patients. The scoring of the sections ranges from 0-100, with higher scores indicating health problems.	1 months

Collaborators and Investigators

• Sponsor: University of Beykent
• Investigators: Study Director: Yasemin ŞAHBAZ, Istanbul Beykent University

Publications and helpful links

General Publications

• Gomoll AH, Katz JN, Warner JJ, Millett PJ. Rotator cuff disorders: recognition and management among patients with shoulder pain. Arthritis Rheum. 2004 Dec;50(12):3751-61. doi: 10.1002/art.20668. No abstract available.
• Galetta MD, Keller RE, Sabbag OD, Linderman SE, Fury MS, Medina G, O'Donnell EA, Cheng TTW, Harris E, Oh LS. Rehabilitation variability after rotator cuff repair. J Shoulder Elbow Surg. 2021 Jun;30(6):e322-e333. doi: 10.1016/j.jse.2020.11.016. Epub 2021 Jan 5.

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2024
• Primary Completion (Actual): June 1, 2024
• Study Completion (Actual): June 22, 2024

Study Registration Dates

• First Submitted: July 23, 2024
• First Submitted That Met QC Criteria: July 30, 2024
• First Posted (Actual): August 2, 2024

Study Record Updates

• Last Update Posted (Actual): August 2, 2024
• Last Update Submitted That Met QC Criteria: July 30, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: Exercise; Pain; Rotator Cuff
• Additional Relevant MeSH Terms: Pathologic Processes; Wounds and Injuries; Disease; Rupture; Shoulder Injuries; Tendon Injuries; Syndrome; Rotator Cuff Injuries
• Other Study ID Numbers: UBeykent-6

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: It was not considered appropriate to share individual information.

Drug and device information, study documents

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