Effect of Muscle Coactivation Strengthening for Rotator Cuff Tendinopathy
Condition: Tendinopathy
MeSH terms: Tendinopathy
Study type: Interventional

Summary: 
      Rotator cuff tendinopathy (RCT) is the most frequent cause of shoulder pain. RCT is
      frequently termed as impingement syndrome, based on the underlying mechanism in which the
      subacromial space soft tissues (subacromial bursa, rotator cuff tendons and long head of the
      biceps tendon) get encroached under the coracoacromial arch when the arm is elevated. RCT
      contributes in the decrease in quality of life and function, and in inducing work
      incapacities and sleep disorders.

      Exercises, as conservative management, were shown to be effective in increasing function and
      in decreasing pain related to RCT. However, the lack of studies comparing different types of
      exercises (i.e. concentric, eccentric, scapular strengthening, proprioceptive, coactivation)
      is reported by many systematic reviews. One type of exercise, coactivation strengthening,
      could be more efficient. Coactivation strengthening implies a recruitment of the pectoralis
      major and the latissimus dorsi while performing regular strengthening. When theses muscles
      are recruited, the medio-inferior orientation of their tendons creates a force vector that
      limits the superior translation of the humeral head, thus limits the subacromial narrowing.

      The aim of this study is to evaluate the efficacy of coactivation strengthening exercises in
      patient with RCT compared to regular strengthening exercises. Forty-two participants
      diagnosed with RCT by an orthopaedic surgeon following a standardized protocol will be
      randomised to either coactivation or regular strengthening exercises. Participants will
      perform a 6-week exercise protocols. Outcomes will be measured at baseline, and at three,
      six, 12, 18 and 24 weeks. The primary outcome is function assessed with the Disabilities of
      arm, shoulder and Hand (DASH) questionnaire. Secondary outcomes focus on pain (visual analog
      scale), quality of life (Western Ontario Rotator Cuff Index), impression of change (Patient
      Global Impression of Change), subacromial distance (ultrasonography) and muscular strength
      (manual dynamometer). Investigators expect that coactivation strengthening exercises will be
      more efficient over the short and long term.

      This trial will provide data to guide clinicians in the treatment of RCT to reduce recovery
      time and to bring patients back as quickly as possible to work or usual function.
    


Intervention name(s): Coactivation Strengthening; Regular Strengthening
Intervention type(s): Procedure; Procedure
Intervention description(s): Coactivation strengthening implies a recruitment of the pectoralis major and the latissimus dorsi while performing regular strengthening.; Regular strengthening implies external rotation, internal rotation, flexion and abduction of the gleno-humeral joint and scapular protraction and retraction of the scapulothoracic joint strengthening.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Rotator Cuff Tendinopathy; Exercises; Coactivation; Strengthening