Effects of a Pectoralis Minor Muscle Stretching Protocol
Condition: Shoulder Pain
MeSH terms: Shoulder Pain
Study type: Interventional
Phase: Phase 4

Summary: 
      The purpose of this study is to verify the effects of a stretching protocol for the
      pectoralis minor muscle on its resting length and on the 3D kinematics of the scapula during
      arm flexion in asymptomatic subjects and patients with impingement syndrome with shortened
      pectoralis minor.
    

Detailed description: 
      Fifty subjects (25 symptomatic and 25 asymptomatic for shoulder pain) will be recruited. All
      of them will be initially assessed twice with one week between the assessments. On each day,
      they will complete two questionnaires (DASH and SPADI) to assess pain and shoulder function.
      The resting length of the pectoralis minor muscle and scapular kinematics data during arm
      flexion will also be measured using an electromagnetic tracking system. Initially, the
      resting length of the pectoralis minor will be measured, and then 3 repetitions of arm
      elevation in the sagittal plane will be completed. The stretching protocol will be performed
      daily for 6 weeks. The stretching will be performed with the subject standing, with 90° of
      arm abduction and 90° of elbow flexion and palm on a flat planar surface. The subject then
      will place the leg opposite to the flat surface in front of the other with slight knee
      flexion and tilt the trunk forward like a rigid block and rotate it slightly increasing the
      horizontal abduction at the shoulder. This procedure will be done 4 times for 1 min and 30s
      interval between repetitions. After the 6 weeks, the subject will have the same variables
      from the initial assessments reassessed. For the questionnaires and length of pectoralis
      minor a two-way ANOVA for repeated measures will be used to check the main effects of group
      and evaluation and whether there is interaction between them. For scapular internal/external
      rotation, upward/downward rotation, and tilt anterior/posterior a three-way ANOVA for
      repeated measures will use to analyze the main effects of group (symptomatic and
      asymptomatic), elevation angle of the arm (30°, 60°, 90° and 120°) and evaluation (1, 2 and
      3) and whether there is evaluation x group x angle interaction. A p value less than 0.05 will
      be considered significant.
    

Intervention name(s): Stretching-Asymptomatic subjects; Stretching-Subjects with shoulder pain
Intervention type(s): Procedure; Procedure
Intervention description(s): The stretching will be performed with the subject standing, with 90° of arm abduction and 90° of elbow flexion and palm on a flat planar surface. The subject then will place the leg opposite to the flat surface in front of the other with slight knee flexion and tilt the trunk forward like a rigid block and rotate it slightly increasing the horizontal abduction at the shoulder. This procedure will be done 4 times for 1 min and 30s interval between repetitions.; The stretching will be performed with the subject standing, with 90° of arm abduction and 90° of elbow flexion and palm on a flat planar surface. The subject then will place the leg opposite to the flat surface in front of the other with slight knee flexion and tilt the trunk forward like a rigid block and rotate it slightly increasing the horizontal abduction at the shoulder. This procedure will be done 4 times for 1 min and 30s interval between repetitions.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: shoulder; pectoralis minor; stretching; scapular kinematics