Investigation of the Effect of Respiratory Exercises on Pain and Functionality in Individuals With Rotator Cuff Syndrome

Study Overview
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Brief Summary
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As it causes pain and disability in individuals with rotator cuff lesions, which is one of the most common causes of shoulder pain, it affects performance in activities of daily living. Shoulder pain significantly affects the quality of life of individuals. The aim of conventional treatment in Rotator Cuff injuries is to reduce the inflammation in the area and to enable the shoulder to perform its normal functions. Conventional treatment is to restore muscle balance in the shoulder area. Muscle balance is achieved by strengthening the teres minor, infraspinatus, and subscapularis, which are also the humeral head depressors, and by strengthening the serratus anterior, levator scapula. For strengthening, the shoulder must have a full range of motion. In our study, stretching exercises, cold pack, Ultrasound, TENS, wand, and Codman exercises, which are classical physiotherapy methods, will be applied to all three groups. There are also studies in the literature investigating the effects of traditional physiotherapy methods on individuals with shoulder Rotator Cuff syndrome. The benefits of breathing exercises on pain, shoulder joint range of motion, and balance have all been researched in the literature. Increased diaphragm activity also guarantees that posture and body positions are maintained healthily. Diaphragm activity generally alters how an individual perceives pain. Diaphragmatic breathing is a therapeutic approach for musculoskeletal disorders.

Detailed Description
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Breathing techniques have been demonstrated to reduce shoulder pain and increase ROM at the literature. However, no study has been found on the effectiveness of breathing exercises applied in addition to conventional physiotherapy in individuals with Rotator Cuff syndrome. Based on all of this knowledge, it was designed for this study to examine the efficacy of breathing exercises used in combination with traditional physiotherapy in patients with Rotator Cuff syndrome.

Official Title
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Investigation of the Effect of Respiratory Exercises on Pain and Functionality in Individuals With Rotator Cuff Syndrome

Conditions
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Rotator Cuff Syndrome

Intervention / Treatment
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* Other: Conventional Treatment
* Other: Respiratory Exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Restricted shoulder joint range of motion Having Rotator Cuff Syndrome Not having had any shoulder surgery Being between the ages of 18 - 65 Exclusion Criteria: Major trauma to the shoulder Anatomical deformities and skeletal system fractures Diagnosed orthopedic or rheumatological diseases Being included in a physiotherapy program in the last 6 months Having a cardiac pacemaker Presence of active infection Myocardial infarction in the last 6 months Participants who have any illness that prevents them from doing the exercises will be excluded from the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: CONTROL<br>Traditional physiotherapy applications will be applied. | Other: Conventional Treatment<br>* Cold pack, ultrasound, TENS, finger ladder, Codman, shoulder wheel, and Wand exercises, as well as stretching and capsule exercises, will be used in addition to conventional physiotherapy. Exercises with a wand will be performed 10 times in each direction. There will be 30 repetitions in each direction of the Codman exercises. 5 days a week, for a total of 30 sessions, the afflicted shoulder will get 6 minutes of daily US treatment, with complete contact to the shoulder area and at a right angle. All patients will receive manual stretching in the shoulder flexion, abduction, extension, external rotation, and internal rotation directions. The physiotherapist will perform these stretches 5 times in each direction, pausing for 20 seconds at the conclusion of each repeat. TENS will be applied for 20 minutes. In addition, a 15-minute cold pack application will be made to the shoulder region. The application of theraband strengthening exercises will depend on the patients' state.<br>|
| Experimental: RESPIRATORY EXERCISES GROUP<br>In addition to traditional physiotherapy and respiratory exercises wiil be applied. | Other: Respiratory Exercises<br>* Diaphragmatic breathing and thoracic expansion breathing exercises will be applied 5 days a week.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numerical Rating Scale (NRS) | NRS is widely used in research and clinical settings to represent pain intensity. NRS is stated as the absence of pain as 0 and the worst possible pain as 10. | from pre-interventional time to post-interventional about 1st week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Goniometric Measurement | In our study, the degrees of flexion, extension, abduction, internal rotation, and external rotation of the affected shoulder will be measured by means of a universal goniometer. Flexion and abduction 0-180 degrees, extension 45 degrees, internal and external rotation 0-90 degrees will be taken as reference. | from pre-interventional time to post-interventional about 1st week | 
| The Disabilities of the Arm, Shoulder and Hand (DASH) | Introduced by the American Academy of Orthopedic Surgeons and other organizations, DASH is a scale that evaluates physical limitations and function in upper extremity problems. The DASH questionnaire includes three sub-parameters. The first part contains 30 questions; 21 questions measure the patient's difficulty in daily life functions, 5 questions measure symptoms, and the other 4 questions measure social function, work, sleep, and self-confidence. A 4-question section (optionally answered Business Model (DASHFS)) measures the patient's disability in working life. | from pre-interventional time to post-interventional about 1st week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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respiratory exercises, rotator cuff syndrome, pain