Effectiveness of Scapular Clock Exercises in Scapular Dyskinesia in Post-Operative Open Heart Surgery Patients

NCT ID: NCT05426694

Last Updated: 2022-06-22

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 30 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-04-15
• Study Completion Date: 2022-06-30

Brief Summary

In patients after open-heart surgery, the complaint of scapular dyskinesia is very common. It occurs due to the weakness of the muscles surrounding the scapula. In this research, investigators checked the effectiveness of scapular clock exercises in scapular dyskinesia, in post-op open heart surgery patients. There were two groups, an intervention "Active group" and a 'control group'. The patients will be randomly assigned to each group equally. The treatment session was given for a period of 4 weeks, with 3 sessions each week. They were assessed before treatment, after 2 weeks and post-intervention.

Detailed Description

Scapular dyskinesia is the malalignment of the scapula. It occurs when the pectoralis muscle (pectoralis minor) becomes tight and there is the weakness of the trapezius muscle (lower fibers). It can commonly occur after open-heart surgery due to incision and prolonged bed rest. In this research, the effectiveness of scapular clock exercises was checked. These exercises can strengthen the weak trapezius muscle and also stretch the tight pectoralis minor muscle. By adding these exercises in cardiac rehabilitation the occurrence of scapular dyskinesia can be reduced. Post-op open heart surgery patients mostly present with complain of shoulder pain. Most of their treatment is directed towards shoulder joint while the scapula is usually ignored. So it is important to add exercises directed towards the scapula along with shoulder.

In this study, The investigators will recruit 30 post-op cardiac surgery patients with complain of shoulder pain, with positive scapular dyskinesia. The sample size was calculated using formula and the values were taken from previous researches. Scapular assistance test and Scapular retraction test was used to find out patients with scapular dyskinesia. The subjects will then be randomly divided into two groups using online randomization generator. The interventional group was receive stretching and strengthening exercises with additional scapular clock exercises and the active control group will receive stretching and strengthening exercises. There was 3 sessions per week, for a period of 4 weeks. The patients was assessed prior to the treatment , then after 2 weeks and later after completion of 4 weeks. The tools for assessment include NPRS for pain, Quick-DASH for activity limitation of shoulder and goniometer for measuring range of motion of shoulder.

Conditions

Scapular Dyskinesis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Group A

The interventional group received stretching and strengthening exercises along with scapular clock exercises. For the first two weeks, only scapular clock exercises were performed by the patient actively. After 2 weeks, the subjects performed scapular clock exercises by using the thera-band.

Group Type: EXPERIMENTAL

Scapular clock exercises

Intervention Type: OTHER

In scapular clock exercises, the hand is placed on the wall in front of your body. Move the hand in direction of 12 and 6 o'clock to elevate and depress the scapula. Then move hands towards 9 o' clock and 3 o'clock direction to protract and retract the scapula. Hold each position for 10 seconds. From 3rd week and onward the patient will use thera-band and then perform clock exercises.

Stretching and strengthening exercises

Intervention Type: OTHER

Stretching and strengthening exercises of shoulder and scapular muscles was performed including wall washes, corner stretch, pectoral muscles stretch and wall push ups.

Group B

The active control group received stretching and strengthening exercises only. The stretching and strengthening exercises include corner stretch, wall-washes and pectoralis minor muscle stretch.

Group Type: ACTIVE_COMPARATOR

Stretching and strengthening exercises

Intervention Type: OTHER

Stretching and strengthening exercises of shoulder and scapular muscles was performed including wall washes, corner stretch, pectoral muscles stretch and wall push ups.

Interventions

Scapular clock exercises

In scapular clock exercises, the hand is placed on the wall in front of your body. Move the hand in direction of 12 and 6 o'clock to elevate and depress the scapula. Then move hands towards 9 o' clock and 3 o'clock direction to protract and retract the scapula. Hold each position for 10 seconds. From 3rd week and onward the patient will use thera-band and then perform clock exercises.

Intervention Type: OTHER

Stretching and strengthening exercises

Stretching and strengthening exercises of shoulder and scapular muscles was performed including wall washes, corner stretch, pectoral muscles stretch and wall push ups.

Intervention Type: OTHER

Other Intervention Names

Stretching and strengthening exercises (Physical Therapy)

Eligibility Criteria

Inclusion Criteria

• Patients whose open heart surgery is done at least 6weeks ago.
• Subjects having shoulder and scapular region pain.
• 50% or less loss of Active ROM of shoulder in abduction, flexion and external rotation.
• Positive Scapular assistance (SAT) and Scapular retraction test.
• Positive findings on observational examination of scapula, showing abnormal prominence of either inferior, medial or superior border of scapula.
• Type I and Type II scapular dyskinesia present
• Consented to take part in the study.

Exclusion Criteria

• • Bilateral shoulder involvement

• History of previous surgery on shoulder
• Shoulder fracture
• Glenohumeral or acromioclavicular joint Arthritis.
• Neuromuscular disorders

• Minimum Eligible Age: 35 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Faisalabad

OTHER

Sponsor Role: lead

Responsible Party

Sana Zahir

Dr Sana Zahir;PT and Dr Aqsa Shahid;PT

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Izza Ayub, MS Physical Therapy

Role: PRINCIPAL_INVESTIGATOR

The University of Faisalabad

Locations

Faisalabad Institute of Cardiology

Faisalābad, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Aqsa Shahid, Doctor of Physical Therapy

Role: CONTACT

ladydocter48@gmail.com

0301-8057342

Sana Zahir, Doctor of Physical Therapy

Role: CONTACT

sanazahir22@gmail.com

0306-6396683

Facility Contacts

Sana Zahir, Doctor of Physical Therapy

Role: primary

sanazahir22@gmail.com

0306-6396683

Aqsa Shahid, Doctor of Physical Therapy

Role: backup

ladydocter48@gmail.com

0301-8057342

Other Identifiers

TUF/DR/DPT/366

Identifier Type: -

Identifier Source: org_study_id