Clinical trial NCT06873022: EMG Biofeedback and NMES of Deltoid in Patients With rTSA
Official title: Electromyography Biofeedback and Neuromuscular Electrical Stimulation of Deltoid in Patients With Reverse Total Shoulder Arthroplasty
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Reverse Shoulder Replacement
Keywords: reverse total shoulder arthroplasty
neuromuscular electrical stimulation
surface electromyography
biofeedback
scapulohumeral rhythm
Lead sponsor: National Taiwan University Hospital
Sponsor class: OTHER
First posted: 2025-03-12
Enrollment: 34
Sex: ALL
Minimum age (years): 20
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: The effect of NMES and surface electromyography (sEMG) biofeedback on the deltoid and associated scapular muscles in scapular kinematics and muscle activation in individual post rTSA

Detailed description: Reverse total shoulder arthroplasty (rTSA) has been the optimal treatment for massive irreparable rotator cuff tears and cuff tear arthropathy. Since scapular kinematics alteration was associated with shoulder disorders, scapular kinematics had been characterized in individuals post rTSA with more upward rotation, external rotation, and posterior tilt of the scapula. In addition, the average scapulohumeral rhythm ranged from 1.1 to 1.6, indicating lower glenohumeral joint movements and higher scapulothoracic movements. It supposed that more scapula upward rotation without adequate humeral elevation can result in the scapula notching. Therefore, strategy to decrease scapular movement or increase humeral movements during arm movements may prevent scapula notching. To compensate for rotator cuff deficiency, the deltoid muscle plays a crucial role post rTSA. Enhancing deltoid function can be accomplished through the use of biofeedback or neuromuscular electrical stimulation (NMES). However, the effect of NMES and surface electromyography (sEMG) biofeedback on the deltoid and associated scapular muscles in scapular kinematics, muscle activation, and muscle balance ratio in individual post rTSA remained unclear. Therefore, the objectives in this study would to (1) determine the immediate effects of NMES with EMG biofeedback to deltoid (D) on the muscle activation of upper trapezius (UT), lower Trapezius (LT) and serratus Anterior (SA) as well as the scapular kinematics (upward/downward rotation, external/internal rotation, anterior/posterior tilting) (2) evaluate the immediate effects of NMES with EMG biofeedback on the muscle balance ratios (D/UT, D/LT, D/SA) and the scapulohumeral rhythm (SHR) during arm elevation in the scapular plane at different range of motion.

Eligibility criteria: Inclusion Criteria:

* (1) age between 20 to 85 years old
* (2) undergoing primary reverse shoulder arthroplasty
* (3) shoulder abduction in scapular plane above 90 degrees
* (4) above 3 months following rTSA

Exclusion Criteria:

* (1) a history of other shoulder surgery on the rTSA shoulder
* (2) a revision rTSA
* (3) a surgery shoulder muscle tendon transfer
* (4) neuromuscular diseases
* (5) cognitive disorders
* (6) contraindications for NMES

Primary outcomes:
measure: Muscle activation
timeFrame: before intervention (baseline) and through intervention completion, an average 15 minutes in each intervention (sEMG biofeedback or NMES)
measure: Scapular kinematics
timeFrame: before intervention (baseline) and through intervention completion, an average 15 minutes in each intervention (sEMG biofeedback or NMES)
Secondary outcomes:
measure: Muscle balance ratios
timeFrame: before intervention (baseline) and through intervention completion, an average 15 minutes in each intervention (sEMG biofeedback or NMES)
measure: Scapulohumeral rhythm
timeFrame: before intervention (baseline) and through intervention completion, an average 15 minutes in each intervention (sEMG biofeedback or NMES)
Other outcomes:
Locations:
city: Taipei City
country: Taiwan
facility: National Taiwan University of school and graduate of physical therapy of Performance Analysis Laboratory
state: Zhongzheng Dist.
Study officials:
affiliation: School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
name: Jiu-Jenq Lin, Ph.D
role: STUDY_CHAIR
References: