Effects of Scapular Therapeutic Exercise on Essential Biomechanical and Neurophysiological Parameters in Shoulder Pain Conditions With Scapular Impairments
Study Details
Study Description
Brief Summary
Shoulder pain is a prevalent and recurrent condition. After a period of shoulder pain, some adaptations could be found, as in scapular muscles and kinematics and/or in nervous system.
It seems important to assess several biomechanical and neurophysiological outcomes to better characterize shoulder pain conditions and to program an intervention plane.
Therapeutic exercise is one of the treatments used for shoulder pain, however there are still doubts and controversial findings regarding exercise focusing the scapular musculature. Thus, the present study aims to assess the effects of an intervention protocol based on scapular therapeutic exercise.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Experimental Scapular Therapeutic Exercise Group Patients in this group will perform therapeutic exercises, recommended for subjects with shoulder pain and focusing the neuromuscular control, stretching and/or strengthening of the scapular muscles |
Other: Experimental Scapular Therapeutic Exercise Group
All subjects will perform a program of scapular therapeutic exercises including: neuromuscular control/strength - scapular therapeutic exercises that leads to, at least, moderate muscular activity levels; and stretching exercises.
The intervention period will be of 8 weeks, considering in-person and/or home sessions.
|
Outcome Measures
Primary Outcome Measures
- Change in shoulder pain [Baseline and one week after intervention]
The intensity of pain will be measured with a self-reported 11-point scale (Numerical Rating Pain Scale), with scores ranging from 0 (no pain) to 10 (maximum pain)
- Change in shoulder function [Baseline and one week after intervention]
Shoulder functional status will be measured with a self-reported 13 items scale (SPADI), which ranges from 0 (fully functional) to 100 (maximum degree of disability).
- Change in scapular muscles activity levels [Baseline and one week after intervention]
Scapular muscles activity levels, during shoulder analytical movements and during a functional task, will be recorded superficially by a wireless electromyographic signal detector system
- Change in scapular muscles ratio [Baseline and one week after intervention]
Ratio between scapular muscles activity levels, during shoulder analytical movements and during a functional task, will be calculated considered the superficially eletromyographic data measured by a wireless electromyographic signal detector system.
- Change in kinematics [Baseline and one week after intervention]
Scapular kinematics and scapulohumeral rhythm, during shoulder analytical movements and during a functional task, will be measured by inertial sensors and described in degrees (°)
- Change in movement quality through time variables [Baseline and one week after intervention]
Movement quality will be assessed considering time to peak acceleration and task completion time, calculated according to the data recorded with inertial sensors
- Change in movement quality through trunk compensation [Baseline and one week after intervention]
Movement quality will be also assessed considering the trunk motion, calculated according to the data recorded with inertial sensors
- Change in movement quality through smoothness [Baseline and one week after intervention]
Smoothness will be calculated by jerk logarithm of data recorded with inertial sensors
Secondary Outcome Measures
- Change in muscle stiffness [Baseline and one week after intervention]
Scapular muscles stiffness will be assessed by myotonometry (using a digital palpation device)
- Change in pressure pain threshold [Baseline and one week after intervention]
An assessment point in the shoulder area will be assessed by the application of a mechanical pressure by an algometer
- Change in pain-related fear [Baseline and one week after intervention]
Assessed with self-reported scales - Tampa Scale for Kinesiophobia, which ranges from 13 (best) to 52 (worst)
- Change in pain catastrophization [Baseline and one week after intervention]
Assessed with a self-reported scale - Pain Catastrophizing Scale, which ranges from 0 (better) to 52 (worst)
- Self-impression of change [One week after intervention]
The patient's individual perspective about his/her condition and changes felt considering the intervention received will be assessed by a self-reported scale - Patient global impression of change scale, which range from 0 [no change (or condition has got worse)] to 7 (a great deal better, and a considerable improvement that has made all the difference)
Eligibility Criteria
Criteria
Inclusion Criteria:
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18 to 65 years old
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Chronic (more than 3 months), continuously or intermittently, non-specific or associated with a diagnostic (except if mentioned in the exclusion criteria) shoulder pain of, at least, moderate intensity
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Presenting scapular alterations as scapular dyskinesis (identified at rest or during motion)
Exclusion Criteria:
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History of shoulder fracture, dislocation, tears, infection or neoplasm
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Shoulder surgery
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Cervical and/or thoracic pathologies or pain associated with active movements of these regions
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Neurological disease
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Body mass index out of the range 18,5-30 kg/m2 and muscular skinfold higher than 20mm
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Inability to perform the exercises
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Current practice of competitive/high-level exercise/sport focusing the upper limb
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Center for Rehabilitation Research, School of Health, Polytechnic of Porto | Porto | Portugal | 4200 - 072 |
Sponsors and Collaborators
- Polytechnic Institute of Porto
- School of Health of Polytechnic Institute of Porto
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto
- Porto Biomechanics Laboratory
- Center for Interdisciplinary Applied Research in Health, Health School of the Setubal, Polytechnic Institute
Investigators
- Principal Investigator: Ana Melo, Polytechnic Institute of Porto
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- CE0108C
- SFRH/BD/140874/2018
- UIDB/05210/2020