Clinical trial NCT06081088: Graded Motor Imagery Training in Shoulder Impingement Syndrome
Official title: The Effectiveness of Graded Motor Imagery Training in Patients With Shoulder Impingement Syndrome
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Shoulder Impingement Syndrome
Pain
Keywords: Shoulder Impingement Syndrome
Mirror Neurons
Pain
Functional Status
Rehabilitation
Lead sponsor: Marmara University
Sponsor class: OTHER
First posted: 2023-10-12
Enrollment: 42
Sex: ALL
Minimum age (years): 25
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The aim of this study is to investigate the effects of Graded Motor Imagery (GMI) training on pain, functionality, disability and daily living activities in patients diagnosed with Shoulder Impingement Syndrome.

Detailed description: In this study 42 voluntary patients with Shoulder Impingement Syndrome, aged between 25-65 years will be randomly divided into two groups; group1: "GMI + Conventional Physiotherapy", group 2: "Conventional Physiotherapy".

All participants will receive treatment with a physiotherapist three times a week for six-weeks (18 sessions). At the end of the 6th week, it will be followed regularly with a six-week home exercise program. It will be evaluated by a physiotherapist three times in total (before treatment, at the end of six-weeks of treatment and after six-weeks of follow-up). In addition, all patients will undergo an interim evaluation in terms of primary outcome measures (VAS and DASH score) at week three. The shoulder pain on activity, at rest and at night will be assessed with Visual Analog Scale (VAS), Joint Range of Motion (ROM) will be measured with digital goniometer, strength of shoulder flexor, abductor, external and internal rotator muscles will be assessed with digital dynamometer, functional status will be evaluated with Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, functional status of the hand will be evaluated with Jebsen-Taylor Hand Function Test (JTHFT), lateralization evaluation will be assessed with the Recognise™ application (Shoulder and Hand), and motor imagery will be evaluated with the Kinesthetic and Visual Imagery Questionnair (KVIQ). Patient satisfaction will be evaluated by the Global Rating of Change scale.

Eligibility criteria: Inclusion Criteria:

* Aged between 25-65 years old,
* Having been diagnosed with Shoulder Impingement Syndrome by physical examination and MRI as a result of shoulder pain lasting at least 3 months,
* Presence of a painful arc between 60° and 120° in shoulder flexion / abduction (elevation) movements,
* The Standardized Mini Mental Test result must be at least 24 points,
* Not having seen imagery practice before,

Exclusion Criteria:

* Having severe mental and communication problems,
* Having undergone surgical treatment on the same upper extremity,
* Presence of acute trauma, peripheral nervous system lesion, fracture or complete tendon rupture in the affected shoulder,
* Presence of other pathologies such as adhesive capsulitis of the shoulder joint complex and glenohumeral instability,
* Presence of radiotherapy history on the same side as the affected shoulder,
* Presence of congenital deformity,
* Symptomatic cervical spine pathology,
* Presence of other neurological or rheumatological disorders affecting upper motor function,
* Having any chronic disease that would prevent participation in the treatment program,
* Having attended a physiotherapy program within the last month.

Primary outcomes:
measure: Pain intensity
timeFrame: Baseline, Interim evaluation (At the end of the 3rd week), After the six-week intervention, After six-weeks of follow-up
measure: Functional Status
timeFrame: Baseline, Interim evaluation (At the end of the 3rd week), After the six-week intervention, After six-weeks of follow-up
Secondary outcomes:
measure: Active Range Of Motion (AROM)
timeFrame: Baseline, After the six-week intervention, After six-weeks of follow-up
measure: Isometric Muscle Strength
timeFrame: Baseline, After the six-week intervention, After six-weeks of follow-up
measure: Functional Status Of the Hand
timeFrame: Baseline, After the six-week intervention, After six-weeks of follow-up
measure: Left/right discrimination (Lateralization)
timeFrame: Baseline, After the six-week intervention, After six-weeks of follow-up
measure: Kinesthetic and Visual Imagery Questionnaire (KVIQ)
timeFrame: Baseline, After the six-week intervention, After six-weeks of follow-up
measure: Global Rating of Change scale (Patient Satisfaction)
timeFrame: After the six-week intervention
Other outcomes:
Locations:
city: Istanbul
country: Turkey
facility: Marmara University
state: Başıbüyük, Süreyyapaşa Başıbüyük Yolu Sk No:4/B, 34854 Maltepe
Study officials:
affiliation: Marmara University
name: MASOUD AMIR RASHEDI BONAB, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Araya-Quintanilla F, Gutierrez-Espinoza H, Jesus Munoz-Yanez M, Rubio-Oyarzun D, Cavero-Redondo I, Martinez-Vizcaino V, Alvarez-Bueno C. The Short-term Effect of Graded Motor Imagery on the Affective Components of Pain in Subjects with Chronic Shoulder Pain Syndrome: Open-Label Single-Arm Prospective Study. Pain Med. 2020 Oct 1;21(10):2496-2501. doi: 10.1093/pm/pnz364.
citation: Sawyer EE, McDevitt AW, Louw A, Puentedura EJ, Mintken PE. Use of Pain Neuroscience Education, Tactile Discrimination, and Graded Motor Imagery in an Individual With Frozen Shoulder. J Orthop Sports Phys Ther. 2018 Mar;48(3):174-184. doi: 10.2519/jospt.2018.7716. Epub 2017 Dec 19.
citation: Louw A, Puentedura EJ, Reese D, Parker P, Miller T, Mintken PE. Immediate Effects of Mirror Therapy in Patients With Shoulder Pain and Decreased Range of Motion. Arch Phys Med Rehabil. 2017 Oct;98(10):1941-1947. doi: 10.1016/j.apmr.2017.03.031. Epub 2017 May 5.
citation: Moseley GL. Graded motor imagery for pathologic pain: a randomized controlled trial. Neurology. 2006 Dec 26;67(12):2129-34. doi: 10.1212/01.wnl.0000249112.56935.32. Epub 2006 Nov 2.