Prevalence of Subacromial Impingement Among Egyptian Swimmers

Study Overview
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Brief Summary
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In the available literature, there are no prevalence studies that show the incidence of subacromial impingement in swimmers in Egypt, this should be considered as it's one of the most commonly reported injuries worldwide in swimmers. There are also no available studies to show the difference in incidence of subacromial impingement between both genders in Egypt. This study is attempting to remedy both research deficits and to reduce the literature gap and to show the prevalence rate of this injury among Egyptian swimmers in different age groups, to help prevent its widespread and to provide data for further investigations. This study would give the Egyptian swimming federation and the Ministry of youth and sports a clear idea about the prevalence rate of swimmer's shoulder at different ages in Egyptian swimmers. Most importantly, this study is to provide the physiotherapy community in Egypt data about this injury, the rate of prevalence and how to prevent it and hopefully would help in further future studies and also to apply it in different countries.

Official Title
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Prevalence of Subacromial Impingement Among Egyptian Swimmers a Cross Sectional Survey Study.

Conditions
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Subacromial Impingement Syndrome

Intervention / Treatment
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* Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 440 swimmers (males and females) , their age between 12 - 25. Professional swimmers only. Complain of anterior shoulder pain while swimming or elevation of shoulder. BMI will be ranged from (18.5 - 24.9 kg/m2 ). All swimmers are under supervision and psychologically, medically stable. All swimmers received a good explanation of the questionnaire and the given study. Exclusion Criteria: Any swimmer who refuse to participate in the study Uncooperative swimmers. Unprofessional swimmers. Participants who play any other sports. Exclude any previous traumatic lesion. Exclude any form of shoulder instability. Take any medication that affects pain perception as NSAIDS.

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 25 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Subgroup (1) Male<br>Includes swimmers from 12 to less than 14 years. | Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .<br>* A mix of tools , special tests and questionarre to help in confirming the diagnosis of subacromial impingement.<br>* Other names: Modified DASH (Disabilities of the Arm, Shoulder, and Hand) questionarre .;|
| Subgroup (2) Male<br>Includes swimmers from 14 to less than 16 years. | Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .<br>* A mix of tools , special tests and questionarre to help in confirming the diagnosis of subacromial impingement.<br>* Other names: Modified DASH (Disabilities of the Arm, Shoulder, and Hand) questionarre .;|
| Subgroup (3): Male<br>Includes swimmers 16 to less than 18 years. | Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .<br>* A mix of tools , special tests and questionarre to help in confirming the diagnosis of subacromial impingement.<br>* Other names: Modified DASH (Disabilities of the Arm, Shoulder, and Hand) questionarre .;|
| Subgroup (4) Male<br>Includes swimmers from 18 to less than 20 years | Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .<br>* A mix of tools , special tests and questionarre to help in confirming the diagnosis of subacromial impingement.<br>* Other names: Modified DASH (Disabilities of the Arm, Shoulder, and Hand) questionarre .;|
| Subgroup (5) Male<br>(1st Team) includes swimmers from 20 - 25 years. | Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .<br>* A mix of tools , special tests and questionarre to help in confirming the diagnosis of subacromial impingement.<br>* Other names: Modified DASH (Disabilities of the Arm, Shoulder, and Hand) questionarre .;|
| Subgroup (1) Female<br>Includes swimmers from 12 to less than 14 years. | Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .<br>* A mix of tools , special tests and questionarre to help in confirming the diagnosis of subacromial impingement.<br>* Other names: Modified DASH (Disabilities of the Arm, Shoulder, and Hand) questionarre .;|
| Subgroup (2) Female<br>Includes swimmers from 14 to less than 16 years. | Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .<br>* A mix of tools , special tests and questionarre to help in confirming the diagnosis of subacromial impingement.<br>* Other names: Modified DASH (Disabilities of the Arm, Shoulder, and Hand) questionarre .;|
| Subgroup (3) Female<br>Includes swimmers 16 to less than 18 years. | Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .<br>* A mix of tools , special tests and questionarre to help in confirming the diagnosis of subacromial impingement.<br>* Other names: Modified DASH (Disabilities of the Arm, Shoulder, and Hand) questionarre .;|
| Subgroup (4) Female<br>Includes swimmers from 18 to less than 20 years. | Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .<br>* A mix of tools , special tests and questionarre to help in confirming the diagnosis of subacromial impingement.<br>* Other names: Modified DASH (Disabilities of the Arm, Shoulder, and Hand) questionarre .;|
| Subgroup (5) Female<br>(1st Team) includes swimmers from 20 - 25 years. | Other: Handheld Dynamometer , Special tests and Modified DASH questionarre .<br>* A mix of tools , special tests and questionarre to help in confirming the diagnosis of subacromial impingement.<br>* Other names: Modified DASH (Disabilities of the Arm, Shoulder, and Hand) questionarre .;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| External / lnternal rotation ratio | Measured by Handheld dynamometer | 1 day | 
| Lift-off test | This test is performed in a standing position, with the examiner observing and testing from standing behind the patient. To perform this test, the patient is asked to place the back of the affected arm (dorsum of the hand) in the mid lumbar spine area. The testing movement involves the patient performing internal rotation (IR), by lifting the hand off the back while the examiner places pressure on the hand. The test is considered to be positive if the patient cannot resist, lift the hand off the back or if she/he compensates by extending the elbow and shoulder. | 1 day | 
| Neers test | Neer's sign In standing the patient's arm was passively elevated in the plane of the scapula while preventing rotation of the scapula. Reproduction of pain at the anterior edge of the acromion/lateral deltoid was considered a positive response for impingement. | 1 day | 
| Hawkins and kennedy test | Hawkins and Kennedy test while sitting, with the elbow flexed to 90, the patient's shoulder was passively elevated to 90 in the sagittal plane and then forcefully rotated medially. Pain indicated a positive test result. | 1 day | 
| Modified QuickDASH questionarre result | The QuickDASH is scored in two components: the disability/symptom section (11 items, scored 1-5) and the optional high performance sport/music or work modules (4 items, scored 1-5) .For Example in the disability / symptoms sections , at least 10 of the 11 items must be completed for a score to be calculated. The assigned values for all completed responses are simply summed and averaged, producing a score out of five.This value is then transformed to a score out of 100 by subtracting one and multiplying by 25 , measures scaled on a 0-100 scale. A higher score indicates greater disability. | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Swimmers, Swimmer's shoulder, Subacromial impingement