Clinical trial NCT02478567: Exercise Training Sequence for Subacromial Impingement Syndrome
Official title: The Effect of Axioscapular and Rotator Cuff Exercise Training Sequence in Patients With Subacromial Impingement Syndrome: A Randomized Crossover Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Subacromial Impingement Syndrome
Lead sponsor: University of Texas Southwestern Medical Center
Sponsor class: OTHER
First posted: 2015-06-23
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: Randomized crossover trial evaluating the impact of exercise training sequence of axioscapular and rotator cuff exercises in patients diagnosed with subacromial impingement syndrome.

Detailed description: While physical therapy is an effective element in the rehabilitation of rotator cuff (RC) disease, the most effective sequence of training interventions has not been defined. The purpose of this study is to determine if there is a difference in pain or function in patients who are given RC strengthening prior to or after initiating scapular stabilization exercises.

The study was a prospective randomized crossover design. 26 men and 14 women, mean age 51, diagnosed with subacromial impingement syndrome (SAIS) were randomly assigned to one of two groups for a comprehensive and standardized rehabilitation program over six visits at an orthopedic outpatient clinic. One group was prescribed a 4-week program of scapular stabilization exercises while the other group began with RC strengthening exercises. The crossover design had each group add the previously excluded four exercises to their second month of rehabilitation.

Eligibility criteria: Inclusion Criteria:

* 18-80 years of age
* diagnosis of Neer Stage I/II subacromial impingement with a primary pain complaint in the shoulder and/or upper arm
* presence of at least two of the following findings: painful arc, weakness in external rotation, positive impingement sign (Hawkins-Kennedy or Neer/Walsh tests), pain and/or weakness with resistance to internal rotation, external rotation, or scapular plane elevation.

Exclusion Criteria:

* concurrent medical co-morbidities including pregnancy, diabetes, and rheumatoid arthritis -
* osteoarthritis greater than grade 2 on the Kellgren-Lawrence scale
* current diagnosis and/or previous history of glenohumeral instability or dislocation
* full-thickness rotator cuff tear
* adhesive capsulitis
* fractures of the scapula, clavicle or humerus
* scapulothoracic or rotator cuff paresis
* shoulder surgery in past year
* inability to speak the English language at a level sufficient to obtain informed consent.

Primary outcomes:
measure: American Shoulder Elbow Surgeon's Outcome Score
timeFrame: 16 weeks
measure: Numeric Pain Score
timeFrame: 16 weeks
measure: Global Rating of Change
timeFrame: 16 weeks
measure: Global Percentage of Improvement
timeFrame: 16 weeks
Secondary outcomes:
Other outcomes:
Locations:
city: Dallas
country: United States
facility: UT Southwestern Medical Center
state: Texas
Study officials:
References: