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IRCT20180627040251N12 IRCT 2025-07-26 Kharazmi University Comparison of Eccentric and Concentric Shoulder Exercises on Pain, Range of Motion, and Electromyographic Activity of Selected Shoulder Muscles in Individuals with Shoulder Impingement Syndrome Comparison of Eccentric and Concentric Shoulder Exercises on Pain, Range of Motion, and Electromyographic Activity of Selected Shoulder Muscles in Individuals with Shoulder Impingement Syndrome 2025-08-01 anticipated 45 Complete https://irct.ir/trial/85010 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: Randomization was performed using a computer-generated random number table. Participants were assigned unique IDs from 1 to 45, and allocation to study groups was determined by sequentially matching these IDs with the random number sequence. This method ensured equal probability of assignment to each group, Blinding description: In this study, the outcome assessor is blind to the groups’ randomization and interventions receiving by participants. in this way, during the evaluation before and after the intervention protocol, they do not make mistakes in their judgments in favor of a specific therapeutic intervention. N/A Shoulder Impingement Syndrome. Intervention 1: First intervention group: Concentric exercise protocol: This protocol will be implemented for 6 weeks and in 18 sessions. Each movement will be performed in 3 sets with 10 repetitions. Monitoring of correct execution of the exercises will be done through weekly review by the examiner. After receiving general stretching exercises, they will perform concentric strengthening exercises for the rotator cuff muscles and around the shoulder. These exercises focus on shortening contraction of the muscles during movement against resistance. The movements include internal rotation of the shoulder, external rotation of the shoulder, and abduction at an angle of 90 degrees of the scapular plane, which will be performed using a resistance band (theraband) and in a sitting or standing position. Participants are required to perform the movements with a painless and controlled range. The intensity of the exercise is selected at a level where the participant can perform the movement with moderate resistance and 10 consecutive repetitions without pain. Each exercise will be performed in 3 sets of 10 repetitions with a 60-second rest between sets. Intervention 2: Second intervention group: Eccentric exercise protocol: This protocol will be implemented for 6 weeks and in 18 sessions. Each movement will be performed in 3 sets with 10 repetitions. Monitoring of correct execution of the exercises will be done through weekly checks by the examiner. After receiving general stretching exercises, the extroversion exercise group will enter the stretching resistance exercise program (eccentric). In these exercises, the three main movements including internal rotation of the shoulder, external rotation of the shoulder joint and abduction at an angle of 90 degrees in the scapular plane are performed using a resistance band (theraband) and in a controlled manner. Participants first perform the movement with the help of the examiner or actively and then in the return phase, they contract the muscle against the tension of the band and in a stretching (extroversion) manner. The main emphasis is on the slow and controlled execution of the eccentric phase (about 3 to 5 seconds). The intensity of the exercise is adjusted so that the individual can perform 10 consecutive repetitions without pain. Perform each exercise in 3 sets of 10 repetitions, with a 60-second rest between sets, for a total of 12 sessions (3 times a week for 6 weeks). Intervention 3: Control group: In the control group, no intervention will take place. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is There is no further information
public Amirhossein Pirkhalili
Shahid Keshvari, Golestan 4 St., Sarv St., Maryam 1, Building A10, Unit 2
Isfahan Iran (Islamic Republic of) 8169334361 +98 31 3633 0402 amirpirkhalili4@gmail.com Kharazmi University scientific Hassan Sadeghi
Mirdamad - Shahid Hesari St. - Shahid Keshvari Complex - Faculty of Physical Education and Sports Sciences
Tehran Iran (Islamic Republic of) 33111-15447 +98 21 2222 8001 hassan.sadeghi81@yahoo.com Kharazmi University Iran (Islamic Republic of) Male athletes aged 17 to 35 with shoulder impingement syndrome, involved in overhead or throwing sports. Shoulder pain persisting for at least three months Absence of passive range of motion restriction indicating adhesive capsulitis Presence of at least 3 positive signs in SIS diagnostic tests (including: Neer test, Hawkins-Kennedy test, Jobe test, painful arc, and resisted external rotation test) 17 years 35 years Male History of shoulder dislocation or fracture in either the affected or contralateral side Cervical radiculopathy or symptoms suggestive of spinal cord involvement Evidence of full-thickness rotator cuff tear (e.g., positive Drop Arm test or rotator cuff muscle strength of grade II or less on the Oxford scale) Systemic diseases (e.g., diabetes, etc.) Previous surgical interventions involving the shoulder, cervical spine, or chest area Positive Beighton & Horan test indicating ligamentous laxity Individuals who have received steroid injections, physiotherapy, or an exercise program within the past 6 months. Acromion deformities and abnormalities Rehabilitation Rehabilitation N/A First intervention group: Concentric exercise protocol: This protocol will be implemented for 6 weeks and in 18 sessions. Each movement will be performed in 3 sets with 10 repetitions. Monitoring of correct execution of the exercises will be done through weekly review by the examiner. After receiving general stretching exercises, they will perform concentric strengthening exercises for the rotator cuff muscles and around the shoulder. These exercises focus on shortening contraction of the muscles during movement against resistance. The movements include internal rotation of the shoulder, external rotation of the shoulder, and abduction at an angle of 90 degrees of the scapular plane, which will be performed using a resistance band (theraband) and in a sitting or standing position. Participants are required to perform the movements with a painless and controlled range. The intensity of the exercise is selected at a level where the participant can perform the movement with moderate resistance and 10 consecutive repetitions without pain. Each exercise will be performed in 3 sets of 10 repetitions with a 60-second rest between sets. Second intervention group: Eccentric exercise protocol: This protocol will be implemented for 6 weeks and in 18 sessions. Each movement will be performed in 3 sets with 10 repetitions. Monitoring of correct execution of the exercises will be done through weekly checks by the examiner. After receiving general stretching exercises, the extroversion exercise group will enter the stretching resistance exercise program (eccentric). In these exercises, the three main movements including internal rotation of the shoulder, external rotation of the shoulder joint and abduction at an angle of 90 degrees in the scapular plane are performed using a resistance band (theraband) and in a controlled manner. Participants first perform the movement with the help of the examiner or actively and then in the return phase, they contract the muscle against the tension of the band and in a stretching (extroversion) manner. The main emphasis is on the slow and controlled execution of the eccentric phase (about 3 to 5 seconds). The intensity of the exercise is adjusted so that the individual can perform 10 consecutive repetitions without pain. Perform each exercise in 3 sets of 10 repetitions, with a 60-second rest between sets, for a total of 12 sessions (3 times a week for 6 weeks). Control group: In the control group, no intervention will take place. Electromyographic activity: Electrical activity of the shoulder muscles is measured using surface electromyography (sEMG) with a Noraxon Wireless EMG device and includes the muscles of the shoulder area. Signals are recorded using bipolar surface electrodes according to the SENIAM protocol. Timepoint: Outcome variables are measured at two time points: before the exercise protocol (pretest) and after the exercise protocol (posttest). Method of measurement: Electromyographic activity: In this study, electrical activity of shoulder muscles will be measured by surface electromyography (sEMG) with the Noraxon Wireless EMG device. Muscle signals will be recorded at 90 degrees of abduction in the frontal, sagital, and scapular planes of motion. The muscles studied include the anterior deltoid, middle deltoid, posterior deltoid, supraspinatus, and infraspinatus. Signals will be recorded with bipolar surface electrodes according to the SENIAM protocol and with a distance of 2 cm between the electrodes. Pain: Shoulder pain is measured using a visual analog scale (VAS) questionnaire. Timepoint: Outcome variables are measured at two time points: before the exercise protocol (pretest) and after the exercise protocol (posttest). Method of measurement: Pain: Pain in this study will be assessed using a visual analog scale (VAS). Range of motion: Active range of motion of the shoulder joint in flexion, abduction, internal rotation, and external rotation will be measured using an EA8161 goniometer manufactured by MSD. Timepoint: Outcome variables are measured at two time points: before the exercise protocol (pretest) and after the exercise protocol (posttest). Method of measurement: Range of motion: In this study, the active range of motion of the shoulder joint in the directions of flexion, abduction, internal rotation, and external rotation will be measured using a goniometer model EA8161 manufactured by MSD. The measurements will be repeated twice by placing the goniometer in standard anatomical positions and their average will be used for analysis. The range of motion will be recorded up to the maximum pain-free point. Kharazmi University Approved 2025-05-25 Kharazmi University Shahid Keshvari Sports Complex, Kosha Street, between Shohareh and Hesari, Shahid Haghani Highway, Tehran (Mirdamad neighborhood) Tehran Tehran Iran (Islamic Republic of)