Clinical Research Directory

Mulligan and Proprioceptive Neuromuscular Facilitation Techniques in Individuals With Rotator Cuff Lesions

This study aims to compare the effects of Mulligan mobilization with movement (MWM) and Proprioceptive Neuromuscular Facilitation (PNF) techniques on pain, functionality, proprioception, and quality of life in individuals diagnosed with rotator cuff lesions. A total of 45 participants aged 30-70 years with partial supraspinatus tears confirmed by clinical and radiological assessment will be randomly assigned to three groups: conventional physiotherapy, Mulligan + conventional physiotherapy, and PNF + conventional physiotherapy. All groups will receive a standardized three-week physiotherapy program, while the Mulligan and PNF groups will additionally undergo their respective manual therapy interventions. Outcome measures will include pain intensity (VAS), shoulder range of motion, functional disability (DASH), joint position sense, and rotator cuff-specific quality of life (RC-QoL). The study seeks to determine which manual therapy approach (Mulligan or PNF) provides superior improvements in clinical outcomes compared with conventional treatment alone.

Estradiol Supplementation and Rotator Cuff Repair

Rotator cuff tears in the shoulder are common causes of pain and disability, often fail to heal with surgery, and tears, worse outcomes after surgery, and failure of healing are associated with estradiol deficiency. In this study, post-menopausal women will be randomized to either estradiol patches or placebo patches after repair of the rotator cuff. The purpose of this study is to determine whether estradiol patches show promise in improving shoulder pain, strength, muscle volumes, and function when given with rotator cuff repair.

Study Comparing Two Anesthetics for Arthroscopic Rotator Cuff Repair

The purpose of this study is to to compare the post-anesthetic recovery time to awake consciousness and hemodynamic and ventilatory capacities for discharge from the Post-Interventional Monitoring Room in patients admitted for shoulder rotator cuff arthroscopy (using local anesthesia versus general anesthesia + local anesthesia).

Comparison of Dynamic Ultrasound Visual Feedback to Manual Feedback on Scapular Stabilizer Activation and Change in the Subacromial Space in Persons With Pain During Shoulder Elevation

Purpose of the Study This study looks at whether using real-time ultrasound images as feedback can help people better activate two important shoulder muscles-the serratus anterior and lower trapezius-compared to standard verbal or visual feedback from a clinician. The study also examines whether this training carries over to everyday arm movements and whether it helps create more space inside the shoulder joint. Why This Matters Shoulder pain is very common. One possible cause is poor movement or poor muscle control of the shoulder blade, which can reduce the space under the shoulder and lead to pain. The serratus anterior and lower trapezius muscles help the shoulder blade move correctly when lifting the arm. Improving how these muscles work may reduce pain and improve shoulder function. How the Study Is Done People with shoulder pain will take part in the study in a university laboratory. They will be randomly placed into one of two groups: One group will receive muscle training with ultrasound images that show their muscles working in real time. The other group will receive standard feedback without ultrasound. Participants will perform specific shoulder exercises targeting the two muscles. Muscle activity will be measured before and after training using specialized sensors. The researchers will also see if the muscle training improves muscle use during a more functional movement, such as lifting the arm to shoulder height. In addition, ultrasound will be used to measure the space inside the shoulder joint before and after training. Why This Is Important for Care If ultrasound feedback is shown to be effective, it could give physical therapists and other clinicians a new tool to help patients better activate key shoulder muscles. This may improve treatment options for people with shoulder pain, especially pain at the top of the shoulder.

Virtual Reality Intervention in Patients With Persistent Shoulder Pain

Shoulder pain is very common and can make daily activities difficult. Many people have shoulder pain for a long time, even after treatment. Common shoulder problems include pain from the shoulder muscles and tendons, a frozen shoulder, or an unstable shoulder. Unfortunately, both surgery and physiotherapy often help only a little. This can be due to many reasons, such as people not continuing their exercises, fear of moving the shoulder, incorrect beliefs about pain, other health problems, or lifestyle factors. Virtual Reality (VR) is a new and promising technology that is already being used to help people with long-lasting pain. By using a VR headset, people can exercise in a motivating and engaging virtual environment. VR may help reduce fear of movement, improve how people feel about their body, make movement easier, and help people stick to their exercises. However, there is still very little research on using VR for long-lasting shoulder pain. The goal of this study is to find out whether a home-based VR exercise program for people with ongoing shoulder complaints is practical and acceptable. The investigators want to know if people are willing and able to use VR at home, whether they continue the treatment, and whether it shows early signs of reducing pain and limitations. They also want to understand who benefits most from VR, in which situations it works best, and why it may or may not help. People aged 16 years and older who have had shoulder pain and limitations for more than three months can take part. This includes people with shoulder tendon-related pain, frozen shoulder, or shoulder instability. The study lasts six weeks and includes three parts. First, participants receive online educational videos about shoulder pain and movement. Second, they take part in three physiotherapy sessions: one in person and two online. Third, participants use a VR headset at home every day for about 15 minutes to perform guided shoulder and whole-body exercises, such as reaching or aiming tasks. The exercises gradually become more challenging. Participants receive clear written and video instructions, and technical support is available if needed. During the study, participants will complete questionnaires and the VR system will record basic usage data. At the end of the study, group interviews will be held with participants and physiotherapists to talk about their experiences with VR and how it influenced pain, movement, and daily activities. Using VR is considered safe. Some people may experience mild and short-lasting side effects, such as dizziness, but serious problems are not expected. The main effort for participants is the time spent on exercises and completing questionnaires. The results of this study will help determine whether VR is a useful and realistic treatment option for people with long-lasting shoulder pain and will guide future, larger studies.

Effect Of Sleeping Posture Guidance On Sleep Quality In Patients With Rotator Cuff Syndrome

This study investigates sleep quality in patients with Rotator Cuff Syndrome (RCS) undergoing physical therapy treatment. Existing literature presents a gap regarding longitudinal studies evaluating the impact of physical therapy and different sleeping positions on sleep quality within this specific population. The central hypothesis is that physical therapy, combined with guidance on the best sleeping positions, reduces pain, improves shoulder function, and consequently promotes an improvement in sleep quality for RCS patients over time. The justification for this research lies in the need to better understand the relationship between physical therapy and sleep quality in RCS patients, aiming for the development of more effective and less invasive interventions. Previous studies have demonstrated that chronic pain, a common symptom of RCS, is intrinsically linked to sleep disturbances, which can lead to deleterious effects such as dopamine reduction, alterations in the descending pain modulation system, and central sensitization. Improvements in sleep quality have been observed after surgical procedures such as shoulder arthroscopy and arthroplasty, often associated with improved function and pain reduction. Thus, this study seeks to longitudinally evaluate whether physical therapy is capable of promoting a sustained improvement in sleep quality for patients with RCS

Does Sarcopenia Influence Rotator Cuff Tear Patterns? Radiological Insights From Patients With Rotator Cuff Syndrome

Sarcopenia is the loss of muscle mass due to aging, which consequently leads to a decline in muscle function. It is considered an independent risk factor for falls and fractures, disability, postoperative complications, and mortality. Rotator cuff tears are known to be influenced by systemic diseases such as diabetes, hypercholesterolemia, thyroid disorders, and osteoporosis. The aim of our study is to investigate whether there is a relationship between sarcopenia and rotator cuff tears, and if so, to determine the location and type of the tear.

Comparison of Rehabilitative Game Exercise and Body Awareness Therapy in Rotator Cuff Syndrome

Rotator cuff syndrome is one of the most common problems in the shoulder, starting as acute tendinopathy and progressing to partial and full thickness tears. Shoulder pain causes a decrease in shoulder joint movement, joint position sense, upper extremity function and quality of life. Among the most commonly used conservative treatment methods; Joint range of motion exercises, stretching exercises, strengthening exercises, mobilization and electrotherapy method are included. Nowadays, with the widespread use of technology in rehabilitation, video-based games have begun to be used for rehabilitative purposes in addition to conservative approaches. Although the effectiveness of video-based games has been extensively studied in diseases such as cerebral palsy, stroke and parkinsonism, there are a limited number of studies in the field of orthopedic rehabilitation, especially in shoulder rehabilitation. Basic body awareness therapy is used to treat chronic musculoskeletal-related painful conditions. In the literature, basic body awareness therapy has been studied in patient groups such as mental health, stroke patient groups, chronic musculoskeletal problems, chronic waist and neck pain, scoliosis and knee osteoarthritis. Studies have shown that the TBFT method provides improvements in individuals' body awareness, mobility in daily living activities, health-related quality of life, body image and pain intensity. However, no studies have been found in which basic body awareness therapy was used in the field of shoulder rehabilitation. Our study aims to compare the effectiveness of a rehabilitative game exercise program and body awareness training in terms of pain, joint range of motion, shoulder functionality, proprioception, body awareness, shoulder-related quality of life, kinesiophobia and patient satisfaction in individuals with Rotator cuff syndrome.

Cross-sectorial Use of Patient-Reported Outcomes in Chronic Degenerative Shoulder Conditions

This research project aims to test if systematic (extensive) use of patient-reported outcomes across treatment boundaries can 1. improve patients' and health professionals' understanding of individual patients' conditions and health changes, 2. improve indications for treatment, 3. strengthen patient empowerment, and 4. reduce patients' utilization of health services. The study will be performed in the particular context of patients with chronic degenerative conditions of the shoulder. These patients are characterized by contact with numerous health professionals from different health sectors, such as general practitioner, physiotherapists and surgical referral centres, which challenges coherence and communication for the individual treatment decisions. The research project will be performed as a randomized controlled trial (RCT) with a 1-year inclusion period and two years of follow-up.

Exercise vs. Supplements in Rotator Cuff-Related Shoulder Pain

Rotator cuff-related shoulder pain is a pathology characterized by pain and functional impairment originating from one or more rotator cuff tendons. The lifetime incidence of rotator cuff-related shoulder pain is around 67%, with an annual incidence exceeding 1%. Many patients continue to experience pain and functional loss for up to one year, and more than half of the patients report shoulder pain persisting for over three years. The pathophysiology underlying rotator cuff-related shoulder pain continues to be a subject of ongoing research and uncertainty, with many aspects yet to be fully elucidated. The most common belief regarding its pathogenesis involves the role of inflammation. This hypothesis is supported by the accumulation of inflammatory cells in tendons, oxidative stress, and increased levels of pro-inflammatory cytokines. In tendon pathologies with inflammatory cell accumulation and increased cytokine levels, the use of antioxidants and anti-inflammatory agents in addition to conservative treatment contributes to tendon healing. Anti-oxidants and anti-inflammatories are substances capable of preventing or delaying certain cell damage.The use of anti-inflammatory and antioxidant supplements such as Vitamin C (Vit-C), Vitamin D (Vit-D), Omega-3, and Magnesium (Mg) is recommended. Despite indicating exercise as the gold standard for managing rotator cuff-related shoulder pain and the demonstrated anti-inflammatory and anti-oxidant properties of the mentioned supplements, there are still gaps in the understanding of their effectiveness in rotator cuff-related shoulder pain. Based on these gaps, the goal of this study is to investigate the effects of supplements (Vit-C, Vit-D, Omega-3, and Mg) given in addition to exercise on patients' blood parameters (TNF-a, IL-6, and CRP levels), pain, functional status, quality of life, and patient satisfaction in individuals with rotator cuff-related shoulder pain.

ADDITIONAL EFFECTS OF MOBILIZATION WITH MOVEMENT WITH UPPER QUADRANT CORE STRENGTHENING IN ROTATOR CUFF RELATED PAIN:A RANDOMIZED CONTROLLED TRAIL

This study is a randomised control trial and the purpose of this study is to determine the additional effects of mobilization with movement with upper quadrant core strengthening in rotator cuff related pain .

Digital Physiotherapy Treatment for Patients With Subacromial Pain Compared to Usual Physiotherapy in Primary Care

The goal of this clinical trial is to test a digital treatment for patients with subacromial pain using the digital Shoulder Aid (diSAID) strategy. The participants in this study will be randomly assigned to digital treatment (diSAID) or to receive the treatment that is currently available in primary care, i.e. continue according to usual practice. The main question this clinical trial aims to answer are: \- Can the diSAID improve shoulder function and reduce pain for patients with subacromial pain in primary care?

Outcomes of Massive Rotator Cuff Tendon Tear Treatment.

Rotator cuff tear is the leading cause of shoulder pain in the elderly. There isn't enough evidence nor clinical guidelines to guide the treatment of massive rotator cuff tears, specially irreparable tears. Arthroscopic partial repair has been widely used and superior capsular reconstruction (SCR), either with allograft, autograft or augmentation with long head biceps brachii tendon (LHBBT), has been recently added. It is showing promising results, but lacking high quality evidence. This is a prospective clinical study to compare the outcomes of different surgical methods for massive rotator cuff tendon tears. Minimal follow-up time will be two years. In this trial, massive rotator cuff tears will be anatomically repaired if possible. For irreparable tears a method will be randomly assigned intra-operatively once a tear is determined to be irreparable - either partial repair or partial repair with superior capsular reconstruction using the long head biceps brachii (LHBB) tendon. Patients who are eligible for the study but refuse operative treatment, will serve as conservative study group. The hypothesis is that massive rotator cuff tears that are reparable will have the best functional outcomes. For irreparable tears, augmentation with LHBBT will give superior results over partial repair.