Effect of Closed-chain Shoulder Girdle Scapular Depression Exercise on Shoulder Impingement Syndrome

Study Overview
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Brief Summary
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forty patients will be assigned randomly into 2 equal groups Study group (n=23) will receive closed-chain shoulder girdle scapular depression exercise in addition to Stretching for posterior capsule & pectoralis minor, Eccentric exercise for external rotators and Strength exercises for serrates anterior and low intensity ultrasound Control group B (n=23) will receive shoulder girdle depression against manual resistance exercise in addition to stretching for posterior capsule & pectoralis minor, eccentric exercise for external rotators and Strength exercises for serrates anterior and low intensity ultrasound . The exercise program will consist of 3 sessions / week for 5 weeks

Detailed Description
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BACKGROUND: Patients with shoulder impingment syndrome report disability, especially during overhead movements, which may hinder activities of daily living . Muscular strengthening training influences the resting position and scapular movement pattern of subjects with shoulder impingement syndrome and improve function of the affected shoulder. Therefore, the focus of treatment for the syndrome is on performing exercises, including stretching, strengthening, and neuromuscular control exercises. Although multiple types of exercise, such as scapular stability exercises, strengthening of the rotator cuff through range, and flexibility exercises for the anterior and posterior shoulder exercise is effective in the management of patients with shoulder impingement syndrome, there is not enough evidence to say whether one mode of exercise is superior to another. RESEARCH QUESTION: Are there any difference between closed-chain shoulder girdle scapular depression exercise and shoulder girdle depression against manual resistance exercise on patients with shoulder impingement syndrome METHODS: forty patients will be assigned randomly into 2 equal groups Study group (n=23) will receive closed-chain shoulder girdle scapular depression exercise in addition to Stretching for posterior capsule & pectoralis minor, Eccentric exercise for external rotators and Strength exercises for serrates anterior and low intensity ultrasound Control group B (n=23) will receive shoulder girdle depression against manual resistance exercise in addition to stretching for posterior capsule & pectoralis minor, eccentric exercise for external rotators and Strength exercises for serrates anterior and low intensity ultrasound . The exercise program will consist of 3 sessions / week for 5 weeks

Official Title
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Comparison Between Closed-chain Shoulder Girdle Scapular Depression Exercise and Shoulder Girdle Depression Against Manual Resistance on Patients With Shoulder Impingement Syndrome

Conditions
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Shoulder Impingement Syndrome

Intervention / Treatment
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* Other: Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients aged from 25 to 45 years old. Patients with shoulder impingement stage I &II as judged by criteria of neer classification. Patients diagnosed by orthopedic surgeon with shoulder impingement, the diagnosis will be confirmed by positive Neer and Hawkins tests. Exclusion Criteria: History of cardiac diseases or dyspnea on exertion Patients with cervical radiculopathy. Patients with shoulder instability. Patients with frozen shoulder. Acute shoulder trauma.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Study grou[p<br>Closed-chain shoulder girdle scapular depression exercise | Other: Exercise<br>* Closed-chain Shoulder Girdle Scapular Depression Exercise<br>|
| Active Comparator: control group<br>Shoulder girdle depression against manual resistance exercise | Other: Exercise<br>* Closed-chain Shoulder Girdle Scapular Depression Exercise<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain will be measured by visual analogue scale | 10cm visual analogue scale (0= no pain, and 10= maximum pain) will be used to determine overall shoulder pain | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Range of motion (flexion and abduction) will be measured by Electronic goniometer | Electronic Goniometer will be used to measure shoulder range of motion (Flexion and abduction) | 20 minutes | 
| Function | shoulder function will be measured by western Ontario Rotator Cuff Questionnaire (WORC). | 30 minutes |