Pragmatic Set of Interventions Versus Scapular Strengthening Exercises on Scapular Dyskinesia in Adhesive Capsulitis

NCT ID: NCT06110000

Last Updated: 2023-10-31

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

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-08

Study Completion Date

2024-01-08

Brief Summary

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The aim of this study is to determine the Effects of pragmatic set of interventions versus scapular strengthening exercises on scapular dyskinesia in adhesive capsulitis.

Detailed Description

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Scapular dyskinesia (SD) is a term that describes a physical impairment in which the scapula's position and motion are altered.Symptoms of SD can be one or a combination of the anterior shoulder pain, Postero-superior scapular pain, superior shoulder pain, proximal lateral arm pain. scapular dyskinesia is commonly found in adhesive capsulitis patients. To determine the scapular dyskinesia with shoulder pain two tests that apply manual assistance to the scapula are lateral scapular slide test and wall push up test.

Pragmatic set of interventions are an important element in rehabilitation, and has improved the treatment of many musculoskeletal and neurological conditions. Scapular strengthening exercises, which aims to improve abnormal scapular movements that commonly occur in people with adhesive capsulitis.

The purpose of this study is to explore the effect of scapular focused exercises on the rehabilitation of adhesive capsulitis, patient with scapular dyskinesia. The importance of scapular rehabilitation in the treatment of scapular dyskinesia and to examine the comparative effect of pragmatic set of intervention with scapular strengthening protocol on scapular dyskinesia.

My study on the effect of a pragmatic set of intervention versus scapular strengthening exercises on scapular dyskinesia in adhesive capsulitis is important because it addresses a gap in the current literature. While both interventions have been shown to improve scapular dyskinesia in patients with adhesive capsulitis, there is a lack of studies comparing the two methods. My study will help determine which intervention is more effective in treating scapular dyskinesia, which will be valuable information for healthcare providers working with patients with adhesive capsulitis

Conditions

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Scapular Dyskinesis Adhesive Capsulitis

Keywords

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Scapular Dyskinesis Adhesive Capsulitis Pragmatic set of interventions strengthening exercise

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants are divided into two groups. Group A assigned to pragmatic group of interventions and group B assigned with scapular strengthening exercises at the beginning of the trial and continue that throughout the length of the trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Blinding,refers to a practice where study participants are prevented from knowing certain information that may somehow influence them-thereby tainting the results.

Study Groups

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pragmatic set of interventions

The pragmatic set included 6 interventions as follows.

1. Pragmatic posterior capsular stretch (PPCS)
2. Serratus anterior stretch (SAS)
3. Rotator cuff facilitation (RCF)
4. Acromioclavicular joint mobilization
5. Pectoralis minor stretch
6. Thoracic manipulation

Group Type EXPERIMENTAL

pragmatic set of interventipons

Intervention Type OTHER

The pragmatic set included 6 interventions as follows.

1. Pragmatic posterior capsular stretch (PPCS)
2. Serratus anterior stretch (SAS)
3. Rotator cuff facilitation (RCF)
4. Acromioclavicular joint mobilization.
5. Pectoralis minor stretch
6. Thoracic manipulation Five to ten sweeps per minute are administered three to four times. The applied force is combined with deep breathing. The subject is asked to report discomfort and the applied force is adjusted.

scapular strengthening exercises

Scapular strengthening exercises will be individualised focusing on Serratus anterior, trapezius, Levator scapulae, Rhomboids.

Serratus anterior;

* Dynamic hug
* Scaption with external rotation
* Diagonal PNF (shoulder flexion, horizontal flexion, external rotation),

Trapezius - Upper trapezius:

* Unilateral shoulder shrug,
* Rowing,
* Forward shoulder flexion,
* Shoulder abduction in scapular plane above 120 degrees.

Middle trapezius:

* Prone shoulder horizontal abduction
* Scaption, horizontal abduction with external rotation

Lower trapezius:

* Unilateral scapular retraction,
* Prone bilateral shoulder external rotation at 90 degrees of abduction,
* Prone shoulder abduction.

Levator Scapulae:

* Horizontal abduction with shrug,
* Horizontal abduction with ER,
* Prone shoulder extension.

Rhomboids:

* ER at 90° of abduction,
* ER at 0° of abduction,
* Horizontal abduction,
* Shoulder extension,

Group Type PLACEBO_COMPARATOR

scapular strengthening exercise.

Intervention Type OTHER

• Subjects in Group B receive strengthening exercises (exercise will perform with 15 repetitions for each set- 3sets/day, 3 days /week for 6 weeks. In Scapular strengthening exercises, treatment protocol will involve the individualized for focus muscle Serratus anterior (Dynamic hug, Scaption with external rotation, Diagonal PNF (shoulder flexion horizontal flexion, external rotation),Trapezius - Upper trapezius (unilateral shoulder shrug, rowing, forward shoulder flexion, shoulder abduction in scapular plane above 120 degrees, Middle trapezius (prone shoulder horizontal abduction, scaption, horizontal abduction with external rotation), Lower trapezius (Unilateral scapular retraction, prone bilateral shoulder external rotation at 90 degrees of abduction, prone shoulder abduction), Levator Scapulae (horizontal abduction with shrug, horizontal abduction with ER, prone shoulder extension, Rhomboids (ER at 90° of abduction, ER at 0° of abduction, Horizontal abduction, Shoulder extension)

Interventions

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pragmatic set of interventipons

The pragmatic set included 6 interventions as follows.

1. Pragmatic posterior capsular stretch (PPCS)
2. Serratus anterior stretch (SAS)
3. Rotator cuff facilitation (RCF)
4. Acromioclavicular joint mobilization.
5. Pectoralis minor stretch
6. Thoracic manipulation Five to ten sweeps per minute are administered three to four times. The applied force is combined with deep breathing. The subject is asked to report discomfort and the applied force is adjusted.

Intervention Type OTHER

scapular strengthening exercise.

• Subjects in Group B receive strengthening exercises (exercise will perform with 15 repetitions for each set- 3sets/day, 3 days /week for 6 weeks. In Scapular strengthening exercises, treatment protocol will involve the individualized for focus muscle Serratus anterior (Dynamic hug, Scaption with external rotation, Diagonal PNF (shoulder flexion horizontal flexion, external rotation),Trapezius - Upper trapezius (unilateral shoulder shrug, rowing, forward shoulder flexion, shoulder abduction in scapular plane above 120 degrees, Middle trapezius (prone shoulder horizontal abduction, scaption, horizontal abduction with external rotation), Lower trapezius (Unilateral scapular retraction, prone bilateral shoulder external rotation at 90 degrees of abduction, prone shoulder abduction), Levator Scapulae (horizontal abduction with shrug, horizontal abduction with ER, prone shoulder extension, Rhomboids (ER at 90° of abduction, ER at 0° of abduction, Horizontal abduction, Shoulder extension)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Both male and females with age range b/w 25-45
* People with adhesive capsulitis (having pain, stiffness, and decrease movements of - external rotation, forward flexion and abduction)
* Scapular dyskinesia (positive lateral scapular slide with difference of 1.5cm when measurements are compared bilaterally)

Exclusion Criteria

* History of shoulder surgery or other significant shoulder injury, neurological or musculoskeletal conditions that may affect shoulder function.
* History of significant medical conditions (e.g., heart disease, cancer) that may affect their ability to participate in the study.
* Pregnant or breast feeder, as the exercise program may not be safe or appropriate for them.
Minimum Eligible Age

25 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Riphah International University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rabiya Noor, Phd

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

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Amina welfare and Trust

Lahore, Punjab Province, Pakistan

Site Status RECRUITING

Countries

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Pakistan

Central Contacts

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Imran Amjad, Phd

Role: CONTACT

Phone: 03324390125

Email: [email protected]

Facility Contacts

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Saba Rafique, MSOMPT

Role: primary

References

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Neviaser AS, Hannafin JA. Adhesive capsulitis: a review of current treatment. Am J Sports Med. 2010 Nov;38(11):2346-56. doi: 10.1177/0363546509348048. Epub 2010 Jan 28.

Reference Type BACKGROUND
PMID: 20110457 (View on PubMed)

Mohamed AA, Alawna M. Effect of Adding Vertical Correction to Dynamic Scapular Recognition on Scapular Dyskinesis and Shoulder Disability in Patients With Adhesive Capsulitis: A Randomized Clinical Study. J Chiropr Med. 2022 Jun;21(2):124-135. doi: 10.1016/j.jcm.2022.02.002. Epub 2022 Apr 4.

Reference Type BACKGROUND
PMID: 35774629 (View on PubMed)

Zhu Y, Blundell JE, Holschuh NM, McLean R, Menon RS. Validation of a Mobile App-Based Visual Analog Scale for Appetite Measurement in the Real World: A Randomized Digital Clinical Trial. Nutrients. 2023 Jan 7;15(2):304. doi: 10.3390/nu15020304.

Reference Type BACKGROUND
PMID: 36678176 (View on PubMed)

Lluch-Girbes E, Requejo-Salinas N, Fernandez-Matias R, Revert E, Vila Mejias M, Rezende Camargo P, Jaggi A, Sciascia A, Horsley I, Pontillo M, Gibson J, Richardson E, Johansson F, Maenhout A, Oliver GD, Turgut E, Jayaraman C, Duzgun I, Borms D, Ellenbecker T, Cools A. Kinetic chain revisited: consensus expert opinion on terminology, clinical reasoning, examination, and treatment in people with shoulder pain. J Shoulder Elbow Surg. 2023 Aug;32(8):e415-e428. doi: 10.1016/j.jse.2023.01.018. Epub 2023 Feb 15.

Reference Type BACKGROUND
PMID: 36796714 (View on PubMed)

Dube MO, Desmeules F, Lewis JS, Roy JS. Does the addition of motor control or strengthening exercises to education result in better outcomes for rotator cuff-related shoulder pain? A multiarm randomised controlled trial. Br J Sports Med. 2023 Apr;57(8):457-463. doi: 10.1136/bjsports-2021-105027. Epub 2023 Feb 16.

Reference Type BACKGROUND
PMID: 36796859 (View on PubMed)

Karaagac A, Arslan SA, Keskin ED. Assessment of pain, scapulothoracic muscle strength, endurance and scapular dyskinesis in individuals with and without nonspecific chronic neck pain: A cross-sectional study. J Bodyw Mov Ther. 2023 Jul;35:261-267. doi: 10.1016/j.jbmt.2023.04.008. Epub 2023 Apr 19.

Reference Type BACKGROUND
PMID: 37330779 (View on PubMed)

Ucurum SG, Karabay D, Ozturk BB, Kaya DO. Comparison of scapular position and upper extremity muscle strength in patients with and without lateral epicondylalgia: a case-control study. J Shoulder Elbow Surg. 2019 Jun;28(6):1111-1119. doi: 10.1016/j.jse.2018.12.010. Epub 2019 Mar 26.

Reference Type BACKGROUND
PMID: 30926184 (View on PubMed)

Other Identifiers

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REC/RCR & AHS/23/0150

Identifier Type: -

Identifier Source: org_study_id