Effectiveness of Structured Closed Kinetic Chain and Video Based Game Exercise Program in Rotator Cuff Lesion
Condition: Rotator Cuff Injuries
MeSH terms: Rotator Cuff Injuries
Study type: Interventional

Summary: 
      Rotator Cuff muscles are injured due to frequent use, repeated subacromial loadings and
      circulatory failure, traction, compression, contusion, subacromial abrasion, inflammation,
      injection and age-related degeneration, causing Rotator Cuff ruptures.Rotator Cuff treatment
      strategies vary according to the stage of the disease. While conservative treatment is
      preferred in Stage 1 and Stage 2 of Rotator Cuff injuries, surgical approaches are performed
      in stage 3. The most common conservative methods used in its treatment are corticosteroid
      injections, nonsteroidal anti-inflammatory drugs and physiotherapy methods. When the
      literature is examined, there is no consensus about physiotherapy methods among conservative
      treatment approaches. It is stated in the literature that there is no standard exercise
      protocol for Rotator Cuff rehabilitation and specific exercise programs are needed. In
      addition, the virtual reality treatment approach, the most common example of the use of
      technology in rehabilitation, has begun to take part in rehabilitation studies. The aim of
      the project is to examine the effectiveness of video-based game exercise therapy in
      individuals with Rotator Cuff rupture, to develop a new exercise protocol with closed kinetic
      chain exercises and to investigate the most effective treatment method for Rotator Cuff
      ruptures.
    

Detailed description: 
      INTRODUCTION: Rotator Cuff muscles are injured due to frequent use, repeated subacromial
      loadings and circulatory failure, traction, compression, contusion, subacromial abrasion,
      inflammation, injection and age-related degeneration, causing Rotator Cuff ruptures. The
      prevalence of rotator Cuff ruptures increases with age, it usually starts at the age of 40,
      and its incidence increases by 54% at 60, and 60-80% at 80. Rotator Cuff treatment strategies
      vary according to the stage of the disease. While conservative treatment is preferred in
      Stage 1 and Stage 2 of Rotator Cuff injuries, surgical approaches are performed in stage 3.
      The most common conservative methods used in its treatment are corticosteroid injections,
      nonsteroidal anti-inflammatory drugs and physiotherapy methods. When the literature is
      examined, there is no consensus about physiotherapy methods among conservative treatment
      approaches. It is stated in the literature that there is no standard exercise protocol for
      Rotator Cuff rehabilitation and specific exercise programs are needed. In recent years,
      closed kinetic chain exercises have become the preferred exercises for the rehabilitation of
      musculoskeletal system problems. In the clinic, these exercises are preferred because they
      put less stress on the healing tissue, which is more functional and safe. In the literature,
      the study involving closed kinetic chain exercises related to Rotator Cuff ruptures is very
      few, and there is no structured exercise protocol in this regard. In addition, the virtual
      reality treatment approach, the most common example of the use of technology in
      rehabilitation, has begun to take part in rehabilitation studies.

      AIM: The aim of the project is to examine the effectiveness of video-based game exercise
      therapy in individuals with Rotator Cuff rupture, to develop a new exercise protocol with
      closed kinetic chain exercises and to investigate the most effective treatment method for
      Rotator Cuff ruptures.

      METHOD: The project will include 45 Rotator Cuff partial ruptures in accordance with the
      inclusion criteria in the Physiotherapy and Rehabilitation Policlinic in Esenler Medipol
      University Hospital. Individuals who have been diagnosed with Rotator Cuff partial rupture
      between the ages of 18-60, who do not have a professional sports history, who have had pain
      for more than 4 weeks, and have not undergone any shoulder surgery will be included in our
      project. Individuals with symptomatic neurological findings of cervical origin, having an
      additional orthopedic problem on the shoulder, having mental problems, and individuals with
      neurological, vascular, cardiac problems that limit function will not be included in our
      project. Pain with Visual Analog Scale, pain threshold with algometer, Functionality with
      Arm, Shoulder and Hand Problems Survey, quality of life with Life Quality Scale with Rotator
      Cuff Patients, normal range of motion and proprioception with Fizyosoft applications,
      shoulder aproximation force with Fizyosoft balance system will be evaluated in all
      participants before and after treatment. Individuals participating in our project will be
      randomly divided into 3 groups. Electrotherapy program will be applied to all individuals.
      conventional exercise therapy will be applied to the first group. An exercise program
      consisting of 3 phases that runs from simple to difficult and includes closed kinetic chain
      exercises and proprioceptive exercises will be implemented in second group. Video group
      exercise program will be applied to the third group. By comparing the groups at the end of
      the treatment, it is aimed to find the most effective treatment method for individuals with
      Rotator Cuff rupture.
    

Intervention name(s): Conventional exercise therapy; Closed Chain Exercise Group; Video Based Exercise Group
Intervention type(s): Other; Other; Other
Intervention description(s): Coldpack, TENS, Ultrasound agents and conventional exercise therapy (codman, wand, isometric exercise) will be applied.; An exercise program consisting of 3 phases that runs from simple to difficult and includes closed kinetic chain exercises and proprioceptive exercises will be implemented in this group.; Closed chain exercises based on video games will be applied. These exercises also include proprioceptive exercises.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Virtual Reality; Exercise; Rotator Cuff Injury