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IRCT20191001044947N1 IRCT 2020-06-14 Shiraz University of Medical Sciences comparing the effect of manual and exercise therapy on pain, function and range of motion in treatment of patients with shoulder impingement syndrome comparing the effect of manual and exercise therapy on pain, function and range of motion in treatment of patients with shoulder impingement syndrome 2020-06-15 anticipated 64 Complete https://irct.ir/trial/42801 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: Samples are randomly allocated into two groups. Randomization will be applied with block randomization method (4 people per block) . This method will be applied by the person how does not has any role in treatment and assessment, Blinding description: Assessor will be unaware and won't have any information about patients. Patients also have no information about which group they are categorized into. The evaluator and therapist will be two different people. N/A shoulder impingement syndrome. Intervention 1: Intervention group: manual therapy: The treatment will last 3 sessions per week for patients. Manual therapy includes ischemic compression on trigger and Mobilization points. mobilization of acromioclavicular joint, sternoclavicular joint, glenohumeral joint, scapulothoracic and thoracic joints will be done in direction of limitation by therapists hand. This technique will be done in 3 sets and duration of each set is 30 seconds. For finding trigger points some muscles like pectoralis major, pectoralis minor, supraspinatus, infraspinatus, teres minor, teres major, deltoid and levator scapula will be assessed. Ischemic compression technique will be performed for each muscle that have trigger point and at least 3 muscles from them should have trigger points. For this technique, pressure will be applied on the trigger points by the therapist's thumb. Gradually this pressure will be increased up to the patient's tolerance . This pressure will be applied for 5 to 15 seconds and based on the patient condition this time can increased up to 2 minutes. Intervention 2: Group2: therapeutic exercise: Treatment will last 3 months. Exercises will be done for 12 weeks. During this period, 7 visits will be done by physiotherapists. The exercises will be done in 3 sets and the repetition of exercise in each set is 15 and therapist will emphasize on posture correction. The Emphasis is on correcting the posture.List of exercises contain these elements: Stretching of capsule 2 times in a day, each time contains 3 set between 30 to 45 seconds. As the patient use his or her healthy hand to hold the back of the involved hand and stretch it on the chest.Exercises in the first 8 weeks must done 2 times per day and after 4 weeks it will be reduced to 1 time per day by 3 sets and 15 repeats.Description of the exercises: 1- Retraction the shoulders in a standing position.2-concentric Full can Exercise for week 1 to 8 and eccentric Full can Exercise for week 9 to 12. In this exercises glenohumeral joint in scapula plane will move foe 30 to 45 degree and Dumbbell and TheraBand will be used as the patient will hold the Dumbbell in her/his hand and then lift the involved shoulder in scapula plane and then release it without help.3- eccentric exercise of infraspinatus muscle and teres minor as the patient lie down on intact side and the involved shoulder will be upward, and elbow will bend 90 degree then Arm will stand still on body side then shoulder will turn slowly inward and then will return back to it initial position with intact hand help. From week 9 to 12 the exercise will prescription in both eccentric and concentric manner as the intact hand won’t help any longer.4- eccentric and concentric exercise for serratus anterior muscle in supine position as the patient lie down with shoulder is bend 90 degree and the elbow is straight, scapula will move upward and downward. from week 9 to 12 the push up plus exercise will substituted as the patient lie in prone position in put his/her hands palm on the ground then move shoulders forward and backward.5- external rotation of shoulders bilateral as the patient standing straight holding a TheraBand by both hands then bend both elbows as the shoulders are turning outward. From week 9 to 12 external rotation will done as both shoulders will lift up as both elbows are bended will substituted. Yes - There is a plan to make this available What will be shared: Personal information will be included in the form. Information can be shared. When: Start access period 1 year after publishing results To whom: every one can access to information Conditions: Any scientific use is permitted. Where to obtain: email:zeynabazin@yahoo.com 09352595647 How to obtain: Send an email to the listed alert and Call after 3 days if you do not receive a reply. Files will be sent within 2 weeks. Comments:
public Zeynab azin
NO31,Alley 4,Isar street,Modares boulevard
Shiraz Iran (Islamic Republic of) 7153743897 0987137352664 stud2281423808@sums.ac.ir Shiraz University of Medical Sciences scientific Zeynab azin
NO31,Alley 4,Isar street,Modares boulevard
shiraz Iran (Islamic Republic of) 7153743897 0987137352664 stud2281423808@sums.ac.ir Shiraz University of Medical Sciences Iran (Islamic Republic of) 1.reports of pain in overhead movement 2.reports of pain in active shoulder movements 3.containing positive Neer/Hawkin Kennedy test 4.the Duration of pain lasts more than 3 months 5.having no traumatic pain 6.feeling the pain in 60 to 120 degree of flexion 7.visual analogue scale must be between 4-10 25 years 62 years Both 1. having any Red flags 2. history of frozen shoulder 3.AC joint dysfunction 4.G.H joint DJD 5.the existence of calcification in the shoulder tendons 6. shoulder Instability 7.Traumatic shoulder disorder 8.Surgery in shoulder, elbow, wrist, neck or scapula 9.Disc bulging 10.Systematic disease such as rheumatoid arthritis. 11.Taking painkillers, cartilage and anti-inflammatory drugs Rehabilitation Rehabilitation Intervention group: manual therapy: The treatment will last 3 sessions per week for patients. Manual therapy includes ischemic compression on trigger and Mobilization points. mobilization of acromioclavicular joint, sternoclavicular joint, glenohumeral joint, scapulothoracic and thoracic joints will be done in direction of limitation by therapists hand. This technique will be done in 3 sets and duration of each set is 30 seconds. For finding trigger points some muscles like pectoralis major, pectoralis minor, supraspinatus, infraspinatus, teres minor, teres major, deltoid and levator scapula will be assessed. Ischemic compression technique will be performed for each muscle that have trigger point and at least 3 muscles from them should have trigger points. For this technique, pressure will be applied on the trigger points by the therapist's thumb. Gradually this pressure will be increased up to the patient's tolerance . This pressure will be applied for 5 to 15 seconds and based on the patient condition this time can increased up to 2 minutes. Group2: therapeutic exercise: Treatment will last 3 months. Exercises will be done for 12 weeks. During this period, 7 visits will be done by physiotherapists. The exercises will be done in 3 sets and the repetition of exercise in each set is 15 and therapist will emphasize on posture correction. The Emphasis is on correcting the posture.List of exercises contain these elements: Stretching of capsule 2 times in a day, each time contains 3 set between 30 to 45 seconds. As the patient use his or her healthy hand to hold the back of the involved hand and stretch it on the chest.Exercises in the first 8 weeks must done 2 times per day and after 4 weeks it will be reduced to 1 time per day by 3 sets and 15 repeats.Description of the exercises: 1- Retraction the shoulders in a standing position.2-concentric Full can Exercise for week 1 to 8 and eccentric Full can Exercise for week 9 to 12. In this exercises glenohumeral joint in scapula plane will move foe 30 to 45 degree and Dumbbell and TheraBand will be used as the patient will hold the Dumbbell in her/his hand and then lift the involved shoulder in scapula plane and then release it without help.3- eccentric exercise of infraspinatus muscle and teres minor as the patient lie down on intact side and the involved shoulder will be upward, and elbow will bend 90 degree then Arm will stand still on body side then shoulder will turn slowly inward and then will return back to it initial position with intact hand help. From week 9 to 12 the exercise will prescription in both eccentric and concentric manner as the intact hand won’t help any longer.4- eccentric and concentric exercise for serratus anterior muscle in supine position as the patient lie down with shoulder is bend 90 degree and the elbow is straight, scapula will move upward and downward. from week 9 to 12 the push up plus exercise will substituted as the patient lie in prone position in put his/her hands palm on the ground then move shoulders forward and backward.5- external rotation of shoulders bilateral as the patient standing straight holding a TheraBand by both hands then bend both elbows as the shoulders are turning outward. From week 9 to 12 external rotation will done as both shoulders will lift up as both elbows are bended will substituted. Measurement Shoulder pain and disability index (SPADI), Goniometry, Visual analogue scale (VAS). Timepoint: pre treatment, post treatment and 1 month after treatment. Method of measurement: Shoulder pain and disability index , Goniometry, Visual analogue scale. Shiraz university of medical science Approved 2019-09-18 Ethics committee of Shiraz University of Medical Sciences No. 31, Alley 4, Isar Street, Shiraz, Boulevard Modares Shiraz Fars Iran (Islamic Republic of)