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Subacromial ImpingementNCT03735485

Comparison of the Proprioceptive Neuromuscular Facilitation and Mobilization In Subacromial Impingement Syndrome

A study testing Conventional Physiotherapy, Shoulder Mobilization and Proprioceptive Neuromuscular Facilitation in people with Subacromial Impingement and Subacromial Impingement Syndrome, run by Sevgi Medical Center at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Aim of the study was to compare the effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) exercises and Shoulder Mobilization (SM) on pain, range of motion (ROM), functionality, and muscle strength in patients with Subacromial Impingement Syndrome (SIS). Read more about this study

Who is it for?
Ages 25 to 65 years
What is being tested?
Conventional Physiotherapy, Shoulder Mobilization and Proprioceptive Neuromuscular Facilitation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
44 participants
Where
1 siteTurkey (Türkiye)
Study dates
3 Mar 2017to 10 Jan 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 25 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged between 25-65 years old,
  • Having the diagnosis of Subacromial Impingement Syndrome (SIS),
  • Having shoulder pain at least for four weeks

Who cannot join

  • Having a neuromuscular disease,
  • Pregnancy,
  • History of cancer,
  • Unstable angina,
  • Having pulmonary and/or vascular problems,
  • History of surgery at neck, shoulder, elbow or/and hand,
Show all 13Show fewer
  • Having communication problems
  • Having systemic anti-inflammatory joint diseases
  • Being contraindicated for electrical stimulation and/or exercise
  • Having cervical disc herniation or radiculopathy
  • History of physiotherapy on the same shoulder due to SIS,
  • A history of corticosteroid injection in the last three months,
  • Any orthopedic, rheumatologic, or congenital condition that effects the targeted shoulder

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Sevgi Medical Center

    Istanbul, Arnavutkoy, 34275

Other trials in Turkey (Türkiye)

About this study

Official title: Comparison of the Effectiveness of Proprioceptive Neuromuscular Facilitation Exercises and Shoulder Mobilization Patients With Subacromial Impingement Syndrome: A Randomised Clinical Trial

Aim of the study was to compare the effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) exercises and Shoulder Mobilization (SM) on pain, range of motion (ROM), functionality, and muscle strength in patients with Subacromial Impingement Syndrome (SIS). Patients received 20 sessions (for 4 weeks) under the supervision of a physiotherapist. Patients were evaluated at baseline, at week two, at week four, and at week sixteen.

Read the detailed description

Aim of the study was to compare the effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) exercises and Shoulder Mobilization (SM) on pain, range of motion (ROM), functionality, and muscle strength in patients with Subacromial Impingement Syndrome (SIS). Forty-four patients were divided into three groups as Group I: Conventional physiotherapy receiving group (control group; n=14), Group II: Conventional physiotherapy + PNF exercises receiving group (PNF group; n=15), and Group III: conventional physiotherapy + SM receiving group (SM group; n=15). Pain, ROM, muscle strength, and functionality were evaluated by using visual analog scale (VAS), goniometer, push-pull dynamometer, Constant-Murley score and The Disabilities of the Arm, Shoulder and Hand (DASH) Score respectively. Patients received 20 sessions in total under supervision of a physiotherapist. Patients were evaluated at baseline, at week two, at week four, and at week sixteen.

Being tested
Conventional Physiotherapy, Shoulder Mobilization, Proprioceptive Neuromuscular Facilitation
Keywords
proprioceptive neuromuscular facilitation, functionality, mobilization, pnf
Medical subject headings
Shoulder Impingement Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Conventional PhysiotherapyOther

    The conventional physiotherapy program consisted of electrotherapy and exercise approaches. The electrotherapy program consisted of infrared (for 15 minutes, from 70 cm distance), conventional Transcutaneous Electrical Nerve Stimulation (TENS) in an encircled region (for 20 minutes; with 4 electrodes, 100 Hz, 100 msec), and therapeutic Ultrasound (for 3 minutes; 1 megahertz (MHz), power: 1,5 W/cm²).

    A physiotherapist supervised exercise program was performed following the electrotherapy program. Elastic resistive exercises were added at the week three. While, the first set of wand exercises and elastic resistive exercises was performed under supervision, two sets of the showed exercises were given as the home exercise program.

  • Shoulder MobilizationOther

    In shoulder mobilization technique while the shoulder joint was placed in the traction, anterior, posterior, and inferior gliding and circumduction were applied to the humerus for 2-3 minutes. All mobilization applications were performed in painless range of motion (ROM) limits. The degree of traction and gliding were increased as the relaxing obtained in the tissues.

  • Proprioceptive Neuromuscular FacilitationOther

    In the Proprioceptive Neuromuscular Facilitation (PNF) program participants received PNF exercises with contract-relax technique, in the patterns of "flexion-abduction-external rotation", "extension-adduction-internal rotation", "flexion-adduction-external rotation" and "extension-abduction-internal rotation" along with the verbal and manual facilitation of the physiotherapist.

Study groups in NCT03735485
Study groupRoleWhat they receive
Group IExperimentalThe control group. Participants in this group received only conventional physiotherapy. Number of the participants were 14.
Receives: Other: Conventional Physiotherapy
Group IIExperimentalThe shoulder mobilization group. Participants in this group received conventional physiotherapy and shoulder joint mobilization techniques. Number of the participants were 15.
Receives: Other: Conventional Physiotherapy; Other: Shoulder Mobilization
Group IIIExperimentalThe Proprioceptive Neuromuscular Facilitation (PNF) group. Participants in this group received conventional physiotherapy and PNF exercises. Number of the participants were 15.
Receives: Other: Conventional Physiotherapy; Other: Proprioceptive Neuromuscular Facilitation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Shoulder pain: VAS

    Pain was defined with Visual Analog Scale (VAS). A 10-cm long horizontal visual analog scale (VAS) with marks 0 point (no pain) and 10 point (unbearable pain) was used for evaluating the pain severity. The patients were asked to mark the representing point of their pain levels. The values were recorded in cm. The pain severity was asked in three occasions as: at resting (VASr), during activity (VASa) and during night (VASn).

    Measured: Change from baseline pain scale of shoulder at week 2, 4 and 16.

  2. Disability of the shoulder

    The Disabilities of the Arm, Shoulder and Hand (DASH) Score was used to evaluate the upper extremity physical function. DASH includes two modules as disability / symptom section and work section. The scores are ranged between 0-100. Higher scores indicate lower functionality.

    Measured: Change from baseline Disabilities of the Arm, Shoulder and Hand (DASH) Score at week 2, 4 and 16.

  3. Function of the shoulder

    In addition to DASH, the Constant-Murley score was used to evaluate the functionality of the shoulder. Constant-Murley score is a 100-point scoring system and consisted of four sub-scores as pain (15 points), daily living activities (20 points), active range of motion (40 points), and muscle strength (25 points).

    Measured: Change from baseline Constant-Murley score at week 2, 4 and 16.

  4. Range of motion

    The active range of motion was assessed by using a universal goniometer.

    Measured: Change from baseline active range of motion at week 2, 4 and 16.

  5. Muscle Strength

    The muscle strength of shoulder flexion, shoulder abduction, shoulder adduction, shoulder external rotation, and shoulder internal rotation were determined by using Baseline Push-Pull (New York, USA) dynamometer. The dynamometer was placed in a 90 degrees angle on the location and the patient was asked to contract in maximum for two seconds and then maintain this position for five seconds. Two assessments were performed, and average values were recorded. Pain was avoided during the measurements.

    Measured: Change from baseline muscle strength of shoulder flexion, shoulder abduction, shoulder adduction, shoulder external rotation, and shoulder internal rotation at week 2, 4 and 16.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Nov 2018
  2. Study start3 Mar 2017
  3. Primary completion2 Oct 2017
  4. Study completion10 Jan 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Factorial
Model description
There were three study groups: 1. The control group: Participants in this group received only conventional physiotherapy treatment. 2. The shoulder mobilization group: Participants in this group received conventional physiotherapy and shoulder joint mobilization techniques as treatment. The Proprioceptive Neuromuscular Facilitation (PNF) group. Participants in this group received conventional physiotherapy and PNF exercises as treatment.
Masking
Single blind
Who is masked
Participant
Enrolment
44 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03735485
Sponsor's protocol ID
SevgiMC
Status last verified
Nov 2018
First submitted
2 Nov 2018
Last updated
8 Nov 2018
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Study Protocol, Statistical Analysis Plan (SAP), Informed Consent Form (ICF), Clinical Study Report (CSR) might be considered to be shared with clinicians studying in the same field one year after the publication of the study.

Publications

  • Andrews AW, Thomas MW, Bohannon RW. Normative values for isometric muscle force measurements obtained with hand-held dynamometers. Phys Ther. 1996 Mar;76(3):248-59. doi: 10.1093/ptj/76.3.248.

    PubMed 8602410
  • Aytar A, Baltaci G, Uhl TL, Tuzun H, Oztop P, Karatas M. The effects of scapular mobilization in patients with subacromial impingement syndrome: a randomized, double-blind, placebo-controlled clinical trial. J Sport Rehabil. 2015 May;24(2):116-29. doi: 10.1123/jsr.2013-0120. Epub 2014 Jul 23.

    PubMed 25054347
  • Bandholm T, Rasmussen L, Aagaard P, Jensen BR, Diederichsen L. Force steadiness, muscle activity, and maximal muscle strength in subjects with subacromial impingement syndrome. Muscle Nerve. 2006 Nov;34(5):631-9. doi: 10.1002/mus.20636.

    PubMed 16921511
  • Bang MD, Deyle GD. Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther. 2000 Mar;30(3):126-37. doi: 10.2519/jospt.2000.30.3.126.

    PubMed 10721508
  • Bennell K, Wee E, Coburn S, Green S, Harris A, Staples M, Forbes A, Buchbinder R. Efficacy of standardised manual therapy and home exercise programme for chronic rotator cuff disease: randomised placebo controlled trial. BMJ. 2010 Jun 8;340:c2756. doi: 10.1136/bmj.c2756.

    PubMed 20530557
  • Bicer A, Ankarali H. Shoulder pain and disability index: a validation study in Turkish women. Singapore Med J. 2010 Nov;51(11):865-70.

    PubMed 21140113
  • Celik D. Turkish version of the modified Constant-Murley score and standardized test protocol: reliability and validity. Acta Orthop Traumatol Turc. 2016;50(1):69-75. doi: 10.3944/AOTT.2016.14.0354.

    PubMed 26854052
  • Celik D, Atalar AC, Sahinkaya S, Demirhan M. [The value of intermittent ultrasound treatment in subacromial impingement syndrome]. Acta Orthop Traumatol Turc. 2009 May-Jul;43(3):243-7. doi: 10.3944/AOTT.2009.243. Turkish.

    PubMed 19717942
  • de Witte PB, Nagels J, van Arkel ER, Visser CP, Nelissen RG, de Groot JH. Study protocol subacromial impingement syndrome: the identification of pathophysiologic mechanisms (SISTIM). BMC Musculoskelet Disord. 2011 Dec 14;12:282. doi: 10.1186/1471-2474-12-282.

    PubMed 22168667
  • Delgado-Gil JA, Prado-Robles E, Rodrigues-de-Souza DP, Cleland JA, Fernandez-de-las-Penas C, Alburquerque-Sendin F. Effects of mobilization with movement on pain and range of motion in patients with unilateral shoulder impingement syndrome: a randomized controlled trial. J Manipulative Physiol Ther. 2015 May;38(4):245-52. doi: 10.1016/j.jmpt.2014.12.008. Epub 2015 Apr 30.

    PubMed 25936465
  • Haik MN, Alburquerque-Sendin F, Moreira RF, Pires ED, Camargo PR. Effectiveness of physical therapy treatment of clearly defined subacromial pain: a systematic review of randomised controlled trials. Br J Sports Med. 2016 Sep;50(18):1124-34. doi: 10.1136/bjsports-2015-095771. Epub 2016 Jun 10.

    PubMed 27288517
  • Kim JJ, Lee SY, Ha K. The effects of exercise using PNF in patients with a supraspinatus muscle tear. J Phys Ther Sci. 2015 Aug;27(8):2443-6. doi: 10.1589/jpts.27.2443. Epub 2015 Aug 21.

    PubMed 26356542
  • Lazaro R. Shoulder impingement syndromes: implications on physical therapy examination and intervention. J Jpn Phys Ther Assoc. 2005;8(1):1-7. doi: 10.1298/jjpta.8.1.

    PubMed 25792938
  • Lombardi I Jr, Magri AG, Fleury AM, Da Silva AC, Natour J. Progressive resistance training in patients with shoulder impingement syndrome: a randomized controlled trial. Arthritis Rheum. 2008 May 15;59(5):615-22. doi: 10.1002/art.23576.

    PubMed 18438933
  • Michener LA, McClure PW, Karduna AR. Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clin Biomech (Bristol). 2003 Jun;18(5):369-79. doi: 10.1016/s0268-0033(03)00047-0.

    PubMed 12763431

Questions about this trial

What is this clinical trial studying?

A study testing Conventional Physiotherapy, Shoulder Mobilization and Proprioceptive Neuromuscular Facilitation in people with Subacromial Impingement and Subacromial Impingement Syndrome, run by Sevgi Medical Center at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Nov 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Shoulder pain: VAS (time frame: Change from baseline pain scale of shoulder at week 2, 4 and 16.). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03735485, which also lists 22 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Nov 2018.

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