Effects of Exercise Trainings on Pain, Function and AHD in Patients With SPS

Study Overview
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Brief Summary
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Abnormal reduction of the AHD has been considered as one of the possible mechanisms in the aetiology of subacromial pain syndrome. Maintenance of the AHD is crucial for prevention and rehabilitation of rotator cuff related disorders. The development of a rehabilitation treatment plan is based in part on the assessment of scapular motion and muscle deficits in patients with shoulder pain. Rehabilitation should be based on the identified impairments. The aim of this study is to investigate the effect of utilizing scapula retraction exercises with or without glenohumeral rotational exercises at gradual shoulder elevation angles into a scapular stabilization program on functionality, pain and AHD in patients with SPS and compare with health population.

Detailed Description
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Coordinated motion between the humerus and scapula is required for pain-free arm movement. Rotator cuff and scapulothoracic muscles dynamically control the subacromial space or acromiohumeral distance (AHD).Scapulothoracic muscles need to provide stability and control in a synchronized fashion to facilitate normal scapulohumeral movement. Scapular upward rotation and posterior tilt is essential to maintain the AHD.Therefore, the force couple function of the rotator cuff muscles play an critical role in opposing the superior migration force that is generated by deltoid muscle and, to maintenance the subacromial space. Abnormal reduction of the AHD has been considered as one of the possible mechanisms in the aetiology of subacromial impingement syndrome. Maintenance of the AHD is crucial for prevention and rehabilitation of rotator cuff related disorders. The development of a rehabilitation treatment plan is based in part on the assessment of scapular motion and muscle deficits in patients with shoulder pain. Rehabilitation should be based on the identified impairments. he aim of this study is to investigate the effect of utilizing scapula retraction exercises with or without glenohumeral rotational exercises at gradual shoulder elevation angles into a scapular stabilization program on functionality, pain and AHD in patients with SPS and compare with health population.

Official Title
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Utilizing Scapula Retraction Exercises With or Without Glenohumeral Rotational Exercises With a Gradual Progression: A Double-Blind Randomized Controlled Trial for Subacromial Pain Syndrome

Conditions
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Subacromial Impingement Syndrome

Intervention / Treatment
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* Other: Scapula Retraction Exercise Group
* Other: Scapula Retraction +Glenohumeral Rotational Exercise Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: painful arc of movement during flexion or abduction; positive Neer or Kennedy-Hawkins impingement signs pain on resisted lateral rotation, abduction or empty can test. Exclusion Criteria: previous shoulder surgery; shoulder pain reproduced by neck movement; clinical signs of full-thickness RC tears; or shoulder capsulitis.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 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
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: scapula retraction exercise group<br>Manual Therapy Stretching Exercises Exercise training focus on scapulothoracic muscles will be applied two times per week total 12 week After 12 week follow-up, patients will proceed to reduced exercise program until the 6-month follow-up. | Other: Scapula Retraction Exercise Group<br>* physiotherapy program consists of manual therapy, supervised stretching and scapulothoracic muscles strengthening exercises and home exercise programme including stretching and strengthening exercises will be applied two times a week total 24 sessions. After 24 sessions completed, patients will proceed to reduced exercise program until the 6-month follow-up.<br>* Other names: scapula stabilization exercises;|
| Experimental: Scapula Retraction +Glenohumeral Rotational Exercise Group<br>Manual Therapy Stretching Exercises Exercise training focus on scapulothoracic muscles Exercise training focus on rotator cuff muscles will be applied two times per week total 12 week After 12 week follow-up, patients will proceed to reduced exercise program until the 6-month follow-up. | Other: Scapula Retraction +Glenohumeral Rotational Exercise Group<br>* physiotherapy program consists of manual therapy, supervised stretching and scapulothoracic and also rotator cuff muscles strengthening exercises and home exercise programme including stretching and strengthening exercises will be applied two times a week total 24 sessions. After 24 sessions completed, patients will proceed to reduced exercise program until the 6-month follow-up<br>* Other names: Scapula stabilization +Glenohumeral Rotational Exercise Group;|
| No Intervention: Control Group<br>Age-sex and hand-dominancy matched healthy controls will be included as a control group (CG) for acromiohumeral distance (AHD) normative data | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional Level | Functional level will be assessed by using Shoulder Pain and Disability Index (SPADİ). All assessment will be recorded at baseline, at the end of the 12-week treatment sessions and 6-month follow-up. | ffrom baseline to twelve week after treatment sessions | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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acromiohumeral distance, pain, functional level, Subacromial Impingement Syndrome