Effects of Diaphragm Muscle Therapy on Pain and Shoulder Movement in Subjects With Rotator Cuff Injuries
Condition: Rotator Cuff Injury; Diaphragm; Relaxation
MeSH terms: Wounds and Injuries; Rotator Cuff Injuries
Study type: Interventional

Summary: 
      A randomised and controlled trial to people diagnosed with rotator cuff injuries who are
      divided into 3 groups of treatment: shoulder myofascial trigger points release, manual
      diaphragm release and diaphragm mobilization through hipopressive gymnastic exercise. The
      pain and range of shoulder movement are assessed before and after the treatment in all the
      participants.

      Hypothesis of the clinical study: the treatment of diaphragm muscle, via manual release or
      active mobilization, has impact on rotator cuff injury symptoms comparing with a standard
      treatment of shoulder myofascial trigger points release.

      Discussion: The relation between shoulder and diaphragm muscle, through innervation (phrenic
      nerve and brachial plexus), embryology and myofascial connections, could lead to include in
      clinical practice the examination and treatment of other structures besides shoulder girdle
      such as diaphragmatic region in rotator cuff injuries.
    

Detailed description: 
      This study is a randomised controlled trial evaluating clinical effects of a diaphragm
      treatment, via manual release or active mobilization, comparing with a standard treatment of
      shoulder myofascial trigger points release.

      A description of the 3 groups of treatment:

        1. - Experimental group 1: 3 diaphragm stretching techniques according to Chaitow, Ward and
           Ricard, performed by a physical therapist are employed in this experimental group during
           10 minutes. The participants are situated in a seated, supine and side bending position.

        2. - Experimental group 2: diaphragm mobilization through active hipopressive gymnastic
           exercise according to Caufriez in two different postures.

        3. - Active comparator group: A ischemic compression technique in most painful myofascial
           trigger points in the infraespinatus and supraespinatus muscle during one minute each
           one.

      The shoulder flexion, abduction and external rotation range of motion will be assessed pre
      and postinterventions, as well as the pressure pain threshold with an algometer and the pain
      experienced by the individual in shoulder mobility with a Numerical Rating Scale.
    

Intervention name(s): Diaphragm manual therapy techniques; Diaphragm mobilization through active hipopressive gymnastic exercise; Ischemic compression techniques in shoulder myofascial trigger points
Intervention type(s): Other; Other; Other
Intervention description(s): 3 diaphragm manual therapy techniques performed by a physical therapist are employed in this experimental group during 10 minutes. The participants are situated in a seated, supine and side bending position.; Diaphragm mobilization through active hipopressive gymnastic exercise in two different postures: standing and standing bending forward.; Ischemic compression techniques in infraespinatus and supraespinatus myofascial trigger points during one minute each muscle. The pressure increases gradually until the individual feels a tolerable pain.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: rotator cuff injury; diaphragm; physical therapy; manual therapy