Comparative Effects of Two Procedures for the Management of Posterior Shoulder Tightness

NCT ID: NCT05128448

Last Updated: 2021-11-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-17

Study Completion Date

2022-02-28

Brief Summary

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This study aims to compare the effects of a self-stretch procedures versus a clinician applied musculoskeletal procedure in individuals with posterior shoulder tightness.

Detailed Description

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Posterior shoulder mobility has been considered a contributing factor to shoulder related movement dysfunction. There is evidence indicating that posterior shoulder tightness (PST) might be present in individuals with impingement related symptoms, post-operative conditions and overhead athletes. Several studies have investigated the effects of musculoskeletal procedures (joint mobilisations and stretch) in subjects with posterior shoulder tightness (PST). This cross-over design aims to compare the differences between a well-established procedure - the crossbody stretch - versus mobilisation with movement, on range of motion and pain pressure threshold of asymptomatic individuals with unilateral PST.

Conditions

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Posterior Shoulder Tightness

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
All measurements will be conducted by research assistants unaware of the interventions applied. Statistical analyses will be performed by a blinded research assistant.

Study Groups

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Mobilisation with movement (MWM)

With the participant standing, the restricted shoulder will rest on the clinician's shoulder in the following starting position: 90 degrees of glenohumeral abduction and 90 degrees of elbow flexion and hand holding a treatment belt. The belt will loop around the clinician and patient and will be held by the participant's contralateral hand. The clinician will apply and sustain a pain free caudal or posterolateralcaudal humeral head mobilisation force (whichever is more comfortable to the subject), followed by an active internal rotation (IR) performed by the patient. The IR movement will be performed to a pain free end of range. If possible, an overpressure with be requested, this is achieved by pulling the belt with the contralateral hand. The overpressure should not produce pain, if it does, it will not be performed.

3 sets of 8 repetitions will be applied, sustaining the end of available range for 2 seconds. An interval of 45 seconds will be respected amongst the repetitions.

Group Type EXPERIMENTAL

Mobilisation with movement (MWM)

Intervention Type OTHER

WMW is a musculoskeletal procedure that aims to improve restricted and/or painful range of movement

Cross-body stretch

With the participant standing, the restricted shoulder will be self-stretched by conducting a horizontal adduction in 90 degrees of shoulder flexion to a level tolerated by the participant. This position will be held for thirty seconds and repeated four times. An interval of forty five seconds will be respected amongst the repetitions.

Group Type ACTIVE_COMPARATOR

Cross-body stretch (CBS)

Intervention Type OTHER

CBS is a self administered stretch that aims to stretch posterior shoulder structures

Interventions

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Cross-body stretch (CBS)

CBS is a self administered stretch that aims to stretch posterior shoulder structures

Intervention Type OTHER

Mobilisation with movement (MWM)

WMW is a musculoskeletal procedure that aims to improve restricted and/or painful range of movement

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Asymptomatic individuals without any history of shoulder pain necessitating medical attention.
* Presence of unilateral restriction of at least 10 degrees of internal rotation deficit during the internal rotation mobility test in 90 degrees of shoulder abduction.

Exclusion Criteria

* Asymptomatic individuals that present with shoulder pain on the assessment day.
* Individuals with chronic conditions not affecting the shoulder.
* Individuals with clinical depression.
* Individuals that used analgesic and/or anti-inflammatory medication in the previous 24 hours of assessment.
* Individuals with fibromialgia.
* Individuals engaged in overhead sports.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Federal University of Health Science of Porto Alegre

OTHER

Sponsor Role lead

Responsible Party

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Rafael Baeske

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marcelo Faria Silva, PhD

Role: STUDY_CHAIR

Federal University of Health Science of Porto Alegre

Locations

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Faculdades Integradas de Taquara

Taquara, Rio Grande do Sul, Brazil

Site Status

Countries

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Brazil

References

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Picavet HS, Schouten JS. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain. 2003 Mar;102(1-2):167-78. doi: 10.1016/s0304-3959(02)00372-x.

Reference Type BACKGROUND
PMID: 12620608 (View on PubMed)

Hall K, Borstad JD. Posterior Shoulder Tightness: To Treat or Not to Treat? J Orthop Sports Phys Ther. 2018 Mar;48(3):133-136. doi: 10.2519/jospt.2018.0605.

Reference Type BACKGROUND
PMID: 29490601 (View on PubMed)

Schwartz C, Croisier JL, Bruls O, Denoel V, Forthomme B. Tight shoulders: A clinical, kinematic and strength comparison of symptomatic and asymptomatic male overhead athletes before and after stretching. Eur J Sport Sci. 2021 May;21(5):781-791. doi: 10.1080/17461391.2020.1785015. Epub 2020 Jul 7.

Reference Type BACKGROUND
PMID: 32635824 (View on PubMed)

Rosa DP, Borstad JD, Ferreira JK, Camargo PR. The Influence of Glenohumeral Joint Posterior Capsule Tightness and Impingement Symptoms on Shoulder Impairments and Kinematics. Phys Ther. 2019 Jul 1;99(7):870-881. doi: 10.1093/ptj/pzz052.

Reference Type BACKGROUND
PMID: 30921461 (View on PubMed)

Tyler TF, Nicholas SJ, Lee SJ, Mullaney M, McHugh MP. Correction of posterior shoulder tightness is associated with symptom resolution in patients with internal impingement. Am J Sports Med. 2010 Jan;38(1):114-9. doi: 10.1177/0363546509346050. Epub 2009 Dec 4.

Reference Type BACKGROUND
PMID: 19966099 (View on PubMed)

Salamh PA, Kolber MJ, Hegedus EJ, Cook CE. The efficacy of stretching exercises to reduce posterior shoulder tightness acutely in the postoperative population: a single blinded randomized controlled trial. Physiother Theory Pract. 2018 Feb;34(2):111-120. doi: 10.1080/09593985.2017.1376020. Epub 2017 Sep 13.

Reference Type BACKGROUND
PMID: 28901811 (View on PubMed)

Salamh PA, Liu X, Kolber MJ, Hanney WJ, Hegedus EJ. The reliability, validity, and methodologic quality of measurements used to quantify posterior shoulder tightness: a systematic review of the literature with meta-analysis. J Shoulder Elbow Surg. 2019 Jan;28(1):178-185. doi: 10.1016/j.jse.2018.07.013. Epub 2018 Oct 1.

Reference Type BACKGROUND
PMID: 30287146 (View on PubMed)

Mine K, Nakayama T, Milanese S, Grimmer K. Effectiveness of Stretching on Posterior Shoulder Tightness and Glenohumeral Internal-Rotation Deficit: A Systematic Review of Randomized Controlled Trials. J Sport Rehabil. 2017 Jul;26(4):294-305. doi: 10.1123/jsr.2015-0172. Epub 2016 Aug 24.

Reference Type BACKGROUND
PMID: 27632891 (View on PubMed)

Salamh PA, Liu X, Hanney WJ, Sprague PA, Kolber MJ. The efficacy and fidelity of clinical interventions used to reduce posterior shoulder tightness: a systematic review with meta-analysis. J Shoulder Elbow Surg. 2019 Jun;28(6):1204-1213. doi: 10.1016/j.jse.2018.12.006. Epub 2019 Mar 20.

Reference Type BACKGROUND
PMID: 30902594 (View on PubMed)

Kang MH, Oh JS. Effects of self-stretching with mobilization on shoulder range of motion in individuals with glenohumeral internal rotation deficits: a randomized controlled trial. J Shoulder Elbow Surg. 2020 Jan;29(1):36-43. doi: 10.1016/j.jse.2019.08.007. Epub 2019 Oct 15.

Reference Type BACKGROUND
PMID: 31627965 (View on PubMed)

Hall K, Lewis J, Moore A, Ridehalgh C. Posterior shoulder tightness; an intersession reliability study of 3 clinical tests. Arch Physiother. 2020 Jul 29;10:14. doi: 10.1186/s40945-020-00084-w. eCollection 2020.

Reference Type BACKGROUND
PMID: 32742721 (View on PubMed)

Oliveira VMA, Pitangui ACR, Gomes MRA, Silva HAD, Passos MHPD, Araujo RC. Shoulder pain in adolescent athletes: prevalence, associated factors and its influence on upper limb function. Braz J Phys Ther. 2017 Mar-Apr;21(2):107-113. doi: 10.1016/j.bjpt.2017.03.005. Epub 2017 Mar 17.

Reference Type RESULT
PMID: 28460708 (View on PubMed)

Other Identifiers

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FACCAT

Identifier Type: -

Identifier Source: org_study_id