Rigid Taping Versus Scapular Stabilizing Exercises in Subacromial Impingement Syndrome
Condition: Impingement Syndrome of Ankle
MeSH terms: Shoulder Impingement Syndrome; Syndrome; Rotator Cuff Injuries
Study type: Interventional

Summary: 
      the current study tends to compare the effect of two different treatment techniques used in
      the rehabilitation of shoulder impingement syndrome. rigid tapping and scapular stabilizing
      exercises will be applied and the level of function and pain intensity will be measured
      before and after the intervention and at 3 months follow up. while both methods of treatment
      used previously, the comparison between their effects is not yet investigated and no data is
      available regarding the superiority of one over the other.
    

Detailed description: 
      Patients will be recruited through a verbal and written announcement from the customers of a
      local out-patient clinic. The appropriate number of patients, diagnosed with SIS, who will
      meet the inclusion criteria and accept to sign a consent form will join the study.

      patients will be assigned randomly into three equal groups using permuted blocks of variable
      sizes. The first group rigid tape (RT) group will receive rigid taping plus a standard
      physical therapy protocol. The second group scapular stabilizing exercises (SSE) group will
      receive scapular stabilizing exercises plus the same standard protocol, and the third group
      (control group) will receive the standard protocol only.

      The inclusion criteria were: positive 4 out of the following clinical signs: empty can test,
      Hawkins sign, Neer' sign, tenderness upon palpation of the greater tuberosity of the humerus,
      and painful movement between 60°_ and 120°(painful arc) Patients will be excluded if they
      demonstrate a previous history of shoulder surgery, cervical spine involvement, upper-limb
      fracture, adhesive capsulitis, joint instability, intraarticular corticosteroids injections
      within the last 2 months During the first interview, all patients will be checked for
      inclusion criteria. then undergo baseline assessment for pain level using a validated version
      of the Visual Analog Scale (VAS). Moreover, the functional level of the shoulder will be
      assessed using shoulder pain and disability index (SPADI). SPADI is a valid and reliable
      scale. it has a score ranging from 0 (normal) to 100 (complete disability). Pain and
      functional level will be assessed again after the end of the treatment period and after 3
      months (following up) 12 weeks-rehabilitation program will be implemented for all patients
      with a frequency of 3 sessions/week. The RT group will receive a bilateral rigid taping
      technique using zinc oxide tape and along with the protective tape. With the participant
      assuming a relaxed standing position, the tape will be applied bilaterally starting from the
      first to the last thoracic vertebra. then, a second tape will be applied to the scapula while
      it assumes a position of scapular depression and retraction. This tape will be applied
      bilaterally and extended from the midpoint of the spine of the scapula to the last thoracic
      vertebra. This taping was applied for 12 weeks and changes every 2 days (3times per week) In
      addition to the rigid tape, a standard physical therapy protocol will be introduced. This
      standard protocol will consist of progressive strengthening exercises for rotator cuff
      muscles. The resistance will be applied first by a red-colored elastic Thera-band. Then
      progressed, using the green-colored band. Each exercise will be performed 10 times /session,
      Self-stretching exercises for levator scapula, posterior deltoid, pectoralis minor, and
      latissimus dorsi muscles. Five repetitions of stretching will be performed for each muscle
      per session In addition to the standard protocol, the SSE group will receive scapular
      stabilizing exercises in the form of wall slides with squat, Wall push-ups with ipsilateral
      leg extension, lawnmower with diagonal squat, resisted retraction to scapula with opposite
      leg squat robbery with squat. ten repetitions / exercises/ session were performed .

      The CG will receive the standard protocol only Statistical analysis: SPSS (Version 16) for
      Windows will be used to analyze the obtained data. Mean± SD and percentage of differences
      will be calculated.

      the current study tends to compare the effect of two different treatment techniques used in
      the rehabilitation of SIS. Rigid tapping and scapular stabilizing exercises will be applied
      then the level of function, and pain intensity will be measured before and after the
      intervention and at 3 months follow-up.

      Detailed Description: Patients will be recruited through a verbal and written announcement
      from the customers of a local out-patient clinic. the appropriate sample size of patients
      diagnosed with SIS who will meet the inclusion criteria will join the study after signing the
      consent form.

      patients will be assigned randomly into three equal groups using permuted blocks. The first
      group (RTG) received rigid taping plus a standard physical therapy protocol. The second group
      (SSEG) received scapular stabilizing exercises plus the same standard protocol, and the third
      group (control group) received the standard protocol only The inclusion criteria were:
      positive 4 out of the clinical signs: empty can test, Hawkins sign, Neer' sign, tenderness
      upon palpation of the greater tuberosity of the humerus, and painful movement between 60°_
      and 120°(painful arc) Subjects will be excluded if they have a previous history of shoulder
      surgery, cervical spine involvement, upper-limb fracture, adhesive capsulitis, joint
      instability, intraarticular corticosteroids injections within the last 2 months During the
      first interview, all subjects will be checked for inclusion criteria. Eligible subjects will
      be assessed for pain level using a validated version of the Visual Analog Scale (VAS).
      Moreover, the functional level of the shoulder will be assessed using shoulder pain and
      disability index (SPADI). It is a valid and reliable scale with a score ranging from 0
      (normal) to 100 (complete disability). Pain and functional level were assessed again after
      the end of the treatment period and after 3months (following up) 12 weeks-rehabilitation
      program will be implemented for all participants with a frequency of 3 sessions/week. The RT
      group will receive a bilateral rigid taping technique using zinc oxide tape and along with
      the protective tape. With the participant assuming a relaxed standing position, the tape will
      be applied bilaterally starting from the first to the last thoracic vertebra. then, a second
      tape will be applied to the scapulae while it assumes a position of scapular depression and
      retraction. This tape will be applied bilaterally and extended from the midpoint of the spine
      of the scapula to the last thoracic vertebra. This taping will be applied for 12 weeks and
      will be changed every 2 days (3times per week) In addition to the rigid tape, a standard
      physical therapy protocol will be conducted. This protocol will consist of progressive
      strengthening exercises for rotator cuff muscles. The resistance was applied first by a
      red-colored elastic Thera-band. Then progressed, using the green-colored band. Each exercise
      will be performed 10 times /session,( Self-stretching exercises for levator scapula,
      posterior deltoid, pectoralis minor, and latissimus dorsi muscles. Five repetitions of
      stretching will be performed for each muscle per session In addition to the standard
      protocol, the SSE group will receive scapular stabilizing exercises in the form of wall
      slides with squat, Wall push-ups with ipsilateral leg extension, lawnmower with diagonal
      squat, resisted retraction to scapula with opposite leg squat robbery with squat. ten
      repetitions / exercises/ session were performed .

      The CG will receive the standard protocol only Statistical analysis: SPSS (Version 16) for
      Windows will be used to analyze the obtained data. Mean± SD and percentage of differences
      will be calculated.
    

Intervention name(s): rigid tapping; scapular stabilizing excercise; therapeutic exercises
Intervention type(s): Other; Other; Other
Intervention description(s): Taping techniques We will use rigid tape and apply it bilaterally. In the rigid tape application, a combination pack of zinc oxide tape and the protective tape will be used. The protective tape will be applied first with no tension. To apply the rigid tape, subjects will be instructed to place their thoracic spine in a neutral position, the rigid tape will be applied bilaterally from the first to the twelfth thoracic vertebra. Subjects will be asked to retract and depress the scapula. The rigid tape will be applied diagonally from the middle of the scapular spine to the twelfth thoracic vertebra; this technique will be applied bilaterally. The rigid tape will be applied 3 times per week and will be applied for 6 weeks.; consisted of:
wall slides with squat,
wall push-ups plus ipsilateral leg extension,
lawnmower with diagonal squat,
resisted scapular retraction with contralateral leg squat and robbery with squat.
Robbery with squat
Resisted shoulder internal rotation with step
Resisted shoulder external rotation with step
Resisted full can with step All resisted exercises were performed with elastic bands with red color-coded resistance levels and progressed through green and blue bands The patient will perform 10 repetitions 3 sets to 15 repetitions 3 sets and 20 repetitions 3 sets weekly.; Pectoralis minor stretching
Posterior shoulder stretching
Levator scapula stretching
Latissimus dorsi stretching ( stretching exercises will be 5 repetitions each session - 3 times per week)
Resisted shoulder internal rotation
Resisted shoulder external rotation
Resisted full can (strengthening exercises will be 510 repetitions each session - 3 times per week) All resisted exercises were performed with elastic bands with red color-coded resistance levels and progressed through green and blue bands NOTE. All resisted exercises were progressed from starting 10 repetitions 3 sets to 15 repetitions 3 sets and 20 repetitions 3 sets weekly, supervising movement quality, presence of pain, and fatigue. If the subject achieves 20 repetitions 3 successfully, heavier resistance with resistance band color-coded loading prescribed from 10 repetitions 3 sets.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: double-blind randomized controlled trial
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Impingement Syndrome- rigid tape-scapular stabilizing