The Effects of Short-term Scapular Control Training in Overhead Athletes With Shoulder Impingement Syndrome
Condition: Shoulder Impingement Syndrome; Scapular Dyskinesis
MeSH terms: Shoulder Impingement Syndrome; Syndrome; Rotator Cuff Injuries
Study type: Interventional

Summary: 
      Subacromial impingement syndrome (SIS) is a common disorder of shoulder joint. SIS has been
      accounted for 44-65 % of all shoulder pain. It is believed that one important contributing
      factor is scapular dyskinesis. Patients with SIS demonstrates scapular dyskinesis, including
      decrease in upward rotation, scapular posterior tilt, and external rotation. Altered muscle
      activity of scapular muscles may contribute to scapular dyskinesis, such as increase in
      activity of upper trapezius, and decrease in activity of lower trapezius and serratus
      anterior. In addition to these changes in neuromuscular control, central nervous system may
      be re-organized in patients with musculoskeletal disorders. Evidence has been reported that
      center of gravity of motor mapping changes, corticospinal excitability decreases and
      inhibition increases in patients with shoulder injuries such as instability, rotator cuff
      tendinopathy and SIS. These corticospinal changes are believed to be related to chronicity of
      symptoms and lack of treatment effects.

      Previous studies have applied many types of treatments to SIS, such as manipulation, taping,
      and exercises. However, most studies mainly focused on the outcomes of pain and function, few
      studies investigated changes in neuromuscular control following treatments. Yet, no study has
      addressed how corticospinal system changes following treatment in patient with shoulder
      injuries. Motor skill training, which has been widely used in training healthy subjects or
      patients with neurological disorders, has been shown to change corticospinal systems,
      including increasing excitability and decreasing inhibition. To our knowledge, no study has
      integrated the concepts of motor skill learning into a short-term treatment or investigated
      the effects of motor skill training on corticospinal systems in patients with SIS. The
      purposes of the study are to investigate the effects of short-term motor skill training on
      pain, neuromuscular control, corticospinal system in patients with SIS, and also to
      investigate whether changes in corticospinal parameters will be related to changes in pain,
      function and neuromuscular control.
    


Intervention name(s): Scapular control training; General exercise
Intervention type(s): Procedure; Procedure
Intervention description(s): Participants in this group will learn how to maintain normal scapular position at first. Then they will progress to moving arm with good scapular control with mirror. Afterward, participants will undergo movements protocol which give different directions of arm movements while keeping scapula in a good alignment. They will also receive scapular-focused exercises. The difficulty of the movement protocol will increase weekly. They will be trained three times per week for 6 weeks with an average duration of 30 min per session.; Participants in this group will receive a general shoulder strengthening with theraband or dumbbell. Load will increase weekly. They will be trained three times per week for 6 weeks with an average duration of 30 min per session.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Corticospinal excitability; Transcranial magnetic stimulation; Motor control training; Scapula-focused exercise