The Influence of Eccentric Training on the Volume and Vascularisation of the Rotator Cuff in Patients With Rotator Cuff Tendinopathy and Healthy Subjects

Study Overview
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Brief Summary
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Patients with rotator cuff tendinopathy make up a large part of the population in physiotherapy practice. The rotator cuff, a shoulder muscle group, plays an important role in causing pain. Tendons suffer large compression and friction, which can lead to degeneration of these tendons. Rehabilitation often leads to unsatisfying results. In Achilles and patella tendinopathy, a new training program called eccentric training has shown very good results. Eccentric training contains exercises during which a force has to be resisted while the muscle lengthens instead of shortens. This would have a larger influence on tendon tissue. Some small studies also show promising results of eccentric training in patients with rotator cuff tendinopathy but the mechanisms behind these results remain unclear. To investigate this, 30 patients with rotator cuff tendinopathy and 30 healthy subjects will be evaluated before and immediately after performing the exercise. Three measurements will be done: ultrasonographic measurement of tendon thickness, power Doppler imaging and measurement of microcirculation around the tendon with Oxygen to see. All measurements are non-invasive, pain free and without risks for the human body.

Official Title
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The Influence of Eccentric Training on the Volume and Vascularisation of the Rotator Cuff in Patients With Rotator Cuff Tendinopathy and Healthy Subjects

Conditions
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Rotator Cuff Tendinopathy

Intervention / Treatment
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* Behavioral: Eccentric exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria Patients: Male/ Female 18-40 years old Unilateral shoulder pain for at least 3 months Pain of at least 3/10 on a visual analogue scale Painful arc or pain at end range abduction 2/3 impingement tests positive 2/4 resistance tests positive Pain at insertion rotator cuff Exclusion Criteria Patients: Spurling test positive Shoulder surgery in the past Osteoarthritis shoulder Full thickness ruptures Inclusion Criteria Healthy subjects: Male/ Female 18-40 years old Exclusion Criteria Healthy subjects: Shoulder pain during the last 3 months Shoulder surgery in the past Neck pain or disability Systemic disease (e.g. Marfan, Ehlers Danlos,…)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 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: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Healthy subjects<br> | Behavioral: Eccentric exercise<br>* Patients and healthy subjects will perform an eccentric exercise during which a weight is lifted along the body and lowered with an extended arm at a slow speed. Weight is determined, based on pain in patients and based on force in healthy subjects.<br>|
| Active Comparator: Rotator cuff tendinopathy<br> | Behavioral: Eccentric exercise<br>* Patients and healthy subjects will perform an eccentric exercise during which a weight is lifted along the body and lowered with an extended arm at a slow speed. Weight is determined, based on pain in patients and based on force in healthy subjects.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tendon thickness measurement | Grey scale ultrasound examination is used. | After 30 minutes rest, before performing the exercise. | 
| Tendon vascularisation examination. | Power Doppler ultrasound examination is used. | After 30 minutes rest, before performing the exercise. | 
| Microcirculation around the tendon examination. | Oxygen to see (spectrophotometry and laser Doppler) will be used. | After 30 minutes rest, before performing the exercise. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tendon thickness measurements. | Grey scale ultrasound examination is used. | 10 minutes after performing the exercise. | 
| Tendon vascularisation examination. | Power Doppler ultrasound examination is used. | 10 minutes after performing the exercise. | 
| Microcirculation around the tendon examination. | Oxygen to see (spectrophotometry and laser Doppler) will be used. | 10 minutes after performing the exercise. |