Myofascial Release in Shoulder Pathologies

Study Overview
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Brief Summary
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Shoulder pathology has a high prevalence in the field of musculoskeletal diagnoses, as well as being a common etiology in cases of disability. Passive and active-assisted kinesitherapy are used in the physiotherapy protocol. These techniques sometimes lead to feedback of fear and increased sensation of pain on the part of the patient that can slow or hinder the optimal recovery. A randomized clinical trial is intended to demonstrate that techniques for myofascial release of muscles important in the biomechanics of the shoulder, it is more effective than kinesitherapy in improving myofascial and also by eliminating the aforementioned unwanted effects and, therefore, improving the recovery of these processes.

Detailed Description
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The purpose of this study was to compare the efficacy of myofascial therapy and kinesitherapy in improving function in shoulder pathology with prolonged immobilization. Design Prospective, single-blind randomized controlled trial. Setting Inpatient department of a secondary university hospital. Participants Shoulder pain patients (N=44) were consecutively recruited and randomly assigned to an intervention or control group. Interventions Patients were randomly assigned to a Control Group, to which conventional kinesitherapy was applied, or to the intervention group to which a Myofascial therapy protocol was applied. Both groups completed a therapeutic exercise program based on specific mobilization and strengthening exercises. Main Outcome Measures The QuickDash questionnaire was the primary outcome, visual analog scale and the passive range of motion of the shoulder joint, grades were the secondary outcomes. The outcomes were evaluated at baseline (T0) and at 4 (T2),

Official Title
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Effectiveness of Myofascial Release in Pathologies of the Shoulder

Conditions
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Humerus Fracture, Rotator Cuff Injuries

Intervention / Treatment
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* Other: Treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Be between 20 and 80 years old. Patients who have been immobilized due to the following diagnoses: Suture of the rotator cuff or fracture of the proximal extremity of the humerus. Have signed the informed consent of acceptance in the participation of the study Exclusion Criteria: Present neurological pathology. Be subdued corticoid therapy. Have anticoagulant treatment or have had it less than a month ago. Insulin-dependent diabetic patients. Patients with hemophilia. Having diagnosed a psychological or psychiatric pathology. Non-intervened displaced humerus fractures.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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
Interventional Model Description: Randomized controlled longitudinal experimental study
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group myofascial treatment<br>The trial group will also be referred by the rehabilitating doctor to the physiotherapy room, these patients will be treated by two physiotherapists with training in myofascial release therapy with which they will carry out a treatment protocol that will consist of myofascial release of the shoulder blade angle, subscapularis and global pectoral technique as well as superficial myofascial release of said musculature with a during 12-15 minutes, in addition to a 30-minute session of active kinesitherapy with exercises and mechanotherapy. Same as the control group. These mobilizations are carried out in the absence of pain, although the difference between joint tension or stretching and pain is explained to the patient. | Other: Treatment<br>* Myofascial release of various muscle groups Treatment of mobilization of the shoulder joint<br>|
| Active Comparator: Group Kinesitherapy treatment<br>This group will be treated in a protocolized way with techniques such as passive kinesitherapy, active-assisted and active kinesitherapy to win mobility. They consist of mobilizing the affected arm in the movements of flexion (upward), separation (towards the outer side) and rotation, these lateral decubitus (bring the hand to the nape of the neck) and internal (bring the hand to the lower back) trying to win joint amplitude. These mobilizations are performed in the absence of pain, although the difference between joint tension or stretching and pain will be explained to the patient. The treatment will be carried out as usual with a duration of about 12-15 minutes of mobilization and about 30 minutes of active kinesitherapy with exercises and mechanotherapy, these consist of active shoulder mobility exercises. Emphasis will be placed on working with the pain threshold so as not to cause damage or negative nociceptive reactions. | Other: Treatment<br>* Myofascial release of various muscle groups Treatment of mobilization of the shoulder joint<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional capacity | Dash Scale. Minimum: 0 Maximum: 100. Higher scores mean a worse outcome | Baseline | 
| Shoulder joint mobility | Goniometer Records | Baseline | 
| Degree of pain | Visual Analog Scale. Minimum: 0 Maximum: 10. Higher scores mean a worse outcome | Baseline | 
| Functional capacity | Dash Scale. Minimum: 0 Maximum: 100. Higher scores mean a worse outcome | Change from Baseline at 4 weeks | 
| Shoulder joint mobility | Goniometer Records | Change from Baseline at 4 weeks | 
| Degree of pain | Visual Analog Scale | Change from Baseline at 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pathology of access to the study | Suture of the rotator cuff or fracture of the proximal limb of the humerus | Baseline | 
| Age | Years | Baseline | 
| Sex | Man or woman | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Shoulder, Pathology, Myofascial release, Clinical trial