Clinical Research Directory

The Role of Pectoralis Minor Tightness in the Development of Rotator Cuff Tears

This study investigates whether tightness of a small chest muscle called the pectoralis minor is associated with the development of rotator cuff tears in the shoulder. Using a propensity score matched case-control design, the study compares patients with rotator cuff tears (case group, n=45) to patients with intact rotator cuffs (control group, n=45). Adults aged 18-55 with shoulder pain who are evaluated by MRI and/or shoulder arthroscopy at Gazi University Hospital may be invited. The case group includes patients found to have rotator cuff tears during arthroscopy. The control group includes patients whose rotator cuff was documented as intact by MRI and/or arthroscopy (e.g., patients treated for labral, SLAP, or instability pathology). Groups are matched 1:1 on age, sex, BMI, occupation, sportive activity and dominant side. Before surgery, a trained clinician measures shoulder posture and pectoralis minor length using simple external tools (a digital caliper and ruler-like square). For arthroscopy patients, the surgeon records general arthroscopic findings. No extra procedures are added for research. We expect to include 90 participants total. The primary hypothesis is that pectoralis minor tightness is more prevalent in patients with rotator cuff tears compared to controls. A secondary hypothesis is that tears in patients with pectoralis minor tightness more often begin on the bursal side. Results may help clinicians understand shoulder mechanics and improve prevention or rehabilitation strategies.

Graded Motor Imagery and Task-Oriented Exercise in Shoulder Impingement

This study aims to compare the effects of graded motor imagery and task-oriented exercise training in individuals with shoulder impingement syndrome. A total of 66 participants aged 25-65 years will be randomly assigned to one of three groups: conventional physiotherapy, graded motor imagery, or task-oriented exercise training. All groups will receive standardized electrotherapy, while the intervention groups will additionally complete 6-week graded motor imagery or task-oriented exercise programs. Primary outcomes include pain intensity, shoulder range of motion, muscle strength, proprioception, functional status, kinesiophobia, laterality recognition, movement imagery ability, and patient satisfaction. Assessments will be conducted before and after the intervention by the same physiotherapist. The study aims to determine whether motor imagery-based or task-oriented rehabilitation provides additional benefits compared with conventional physiotherapy in individuals with shoulder impingement syndrome.

Impact of Core Stability Training on Function in Patient With Shoulder Impingement Syndrome Among Manual Operated Hand Workers

Even at the early stage of employment exposure to mechanical factors such as lifting heavy weights, working with hands at or above shoulder level, and pushing or pulling heavy loads are independent risk factors for new-onset shoulder pain . Shoulder-related problems among workers doing spading are 53.1% and 57.7% among workers brick carrying tasks, these shoulder issues may be the result of repetitive awkward movement (beyond ninety degree raising with abduction position) of the shoulder during these activities .

Performance and Safety of LightForce® Therapy Lasers on Shoulder Soft Tissue Inflammation Pain Reduction

DJO UK Ltd (ENOVIS) is conducting this study to assess the effectiveness of LightForce® Therapy Lasers on pain reduction in shoulder soft tissue inflammation. In detail this study will assess superiority of LightForce® Therapy Lasers combined with standard of care, represented by physiotherapy/exercise program compared to sham laser combined with standard of care (physiotherapy/exercise program) on pain reduction in subjects with shoulder soft tissue inflammation due to Impingement (Subacromial impingement syndrome (SAIS)) or Rotator Cuff Tendinopathy (RCT),. In addition, this study allows to collect post market clinical data on the safety and performance of LightForce® Therapy Lasers, when used, following the normal clinical practice, in accordance with its approved and CE marked intended use.

Effectiveness of Kinesiologic Taping and Dry Needling in the Treatment of Subacromial Pain Syndrome

This study aims to compare the effectiveness of two common physiotherapy methods, Kinesiologic Taping (KT) and Dry Needling (DN), in the treatment of Subacromial Pain Syndrome (SAPS), a frequent cause of shoulder pain. The trial also investigates whether using KT and DN together provides greater benefits than using them separately. The main goal is to determine which treatment approach is more effective in reducing pain and improving shoulder function in patients with SAPS.

The Effects of Dynamic Taping With Exercise on Neuromuscular Control in Individuals With Subacromial Impingement

Background: Subacromial Impingement Syndrome (SIS) is the commonest disorder of the shoulder, accounting for 44%-65% of all complaints of shoulder pain. Previous studies have found kinematic changes and alterations in muscle activation amplitude or timing. Recent studies also show the different organization of the corticospinal system in patients with SIS and alterations in central motor representation in individuals with rotator cuff tendinopathy. To restore kinematic changes and muscle activation in patients with SIS, treatments of patients with SIS commonly include motor control exercise and taping. However, there are different types of taping with different properties and purposes resulting in inconsistent outcomes. Recently, a new taping technique, Dynamic tape whose properties are between the most common taping Kinesio tape and rigid tape may solve the questions above. But the evidence of the effect of Dynamic tape and the additional effect of Dynamic tape with motor control exercises are still not well understood. Purpose: The purpose of this study is to investigate the additional effects of Dynamic taping with motor control exercise compared to motor control exercise alone on kinematic, muscle activity, corticospinal excitability, pain and function in people with subacromial Impingement Syndrome. Methods: This is a randomized control trial. Fifty individuals with SIS will be randomly assigned into either an exercise group or dynamic tape with exercise group. Both groups will receive 5 sessions of treatment in 2 weeks, with 30 minutes per sessions. Outcomes will be measured at baseline, after the first intervention and following 2-week intervention. Primary outcome measures will include scapular kinematics, scapular muscle activation and corticospinal system. Secondary outcome measures included shoulder pain by a numeric pain rating scale and shoulder function by the disability of the arm, shoulder \& hand scale (DASH). Data analysis: two-way and three-way mixed ANOVA will used to compare the intervention effect of two groups.

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.

Electromyographic Activity of Posterior Oblique Sling Muscles in Patients With Shoulder Impingement Syndrome

this study aims to assess the gluteus maximus muscle electromyographic activity and the latissimus dorsi muscle electromyographic activity in patients with shoulder impingement syndrome , to improve the assessment procedure and the rehabilitation program for treating patients with shoulder impingement syndrome more effectively. .

Role of Dynamic Ultrasound in Assessment of Shoulder Impingement Syndrome

This study aims to evaluate the effectiveness of dynamic high-resolution ultrasonography in identifying various abnormalities of the shoulder impingement syndrome, especially the subacromial type, and to determine the added value of dynamic ultrasonography compared to static examination of such cases. Furthermore, we will compare these findings to MRI, which we regard as the standard in our cases.

The Clinical Efficacy of Different Durations of Suprascapular Nerve Pulsed Radiofrequency

Chronic shoulder pain due to impingement syndrome and supraspinatus tendinosis is a debilitating condition. Suprascapular nerve innervates most part of shoulder joint. Supraspinatus nerve block can be used as a part of pain therapy. However, its efficacy is short-lasting. To prolong analgesia, short bursts of electrical stimulation to suprascapular nerve may be applied. To the date there is no consensus about duration of these type of stimulation. Investigators' aim is to investigate efficacy of two different duration of stimulation (pulsed radiofrequency) on chronic shoulder pain.

Effect of High Intensity Laser on Shoulder Impingement.

Treatment for shoulder impingement is conservative initially, Rehabilitation programs generally consist of exercise therapy and manual therapy that provide relief from symptoms of impingement. High-intensity laser therapy used recently and was found to be effective in the short term in the treatment of pain and disability in patients with impingement. This study aims to * Investigate the effect of high intensity power laser therapy on sonographic measurement in the adolescent suffering from shoulder impingement syndrome. * Investigate the effect of high intensity power laser therapy on pain in the adolescent suffering from shoulder impingement syndrome. * Investigate the effect of high intensity power laser therapy on shoulder function in the adolescent suffering from shoulder impingement syndrome. RESEARCH QUESTION: Does using high intensity power laser affects shoulder dysfunction in adolescent with shoulder impingement syndrome?

The Effect of Lower Limb Kinetic Chain Exercise in Shoulder Impingement

The goal of this clinical trial study is to investigate the effect of performing lower limb kinetic chain exercise on muscle activation of scapular muscle strength ratio in patients with shoulder impingement. the main question it aims to answer is: Does the addition of lower limb kinetic chain exercise to a shoulder exercise program improve scapular muscles strength ratio in patients with shoulder impingement? participants will be devided into two groups to be compared: The first group will be given a rehabilitation program consisting of strengthening exercises (for scapular stabilizers and rotator cuff) and stretching exercises (for pectoralis major, pectoralis minor, latissimus dorsi, levator scapula) The second group will be given the same exercises in addition to lower limb kinetic chain exercise

Shoulder Impingement Syndrome and Graded Motor Imagery

Graded motor imagery (GMI): used successfully in chronic, complex and painful clinical conditions accompanied by many pain and movement problems; It is a treatment, education and rehabilitation process that is based on recently obtained scientific data and current clinical studies, is individually adapted and approaches the individual holistically with a biopsychosocial model. Nowadays, it is frequently used in the treatment of some neurological diseases. In addition, these approaches are also used in the treatment of some orthopedic diseases including chronic pain. There are a limited number of studies in which the mentioned approaches are used together in stages, and the stages are mostly used alone. There is only one study in the literature on subacromial pain syndrome (SAS), which is the most common cause of shoulder pain and causes radiator cuff problems. Stage 2 SAS patients were included in the study and only one phase of GMI treatment was used in addition to the traditional physiotherapy program. Despite these positive results in favor of GMI, the fact that there is no study using the entire GMI treatment in SAS shows us that a randomized controlled and blinded study with high evidence value should be conducted on this subject. In addition, determining the effect of GMI on changes in central nervous system such as fear of pain, two-point discrimination, and left/right lateralization speed and accuracy task will help fill the literature gaps on this subject. In the light of this information, the question of planned master's thesis study is the effect of GMI treatment applied in addition to traditional physiotherapy in SAS on pain level, joint range of motion, functionality, pain-related fear, two-point discrimination and left/right lateralization speed and accuracy compared to only traditional physiotherapy. whether it is superior or not.

Comparative Effects of ART and STM in Shoulder Impingement Syndrome

Shoulder impingement syndrome is primary cause of discomfort and restricted range of motion while reaching above in shoulder region. It is third most common illness affecting musculoskeletal system. The aim of this study will be to analyse comparative effects of active release technique and soft tissue mobilization on pain, range of motion and disability in shoulder impingement syndrome. The study will be a randomized clinical trial. A random sample of 40 subjects with shoulder impingement from Allied hospital, Faisalabad will be evaluated. Subjects who will meet selection criteria will be allocation into two groups by computerized generated allocation method. In addition to ultrasound as baseline treatment group a will receive active release technique while in group B soft tissue mobilization will be administrated for 4 weeks. Treatment session will be 12 session (3 sessions in one week). Baseline, at 2nd week and at 4th week of treatment pain, shoulder elevation, external rotation and shoulder disability will be measure by VAS, goniometer and SPADI. For, data analysis, we will use SPSS software version 23. Data was interrupted through independent t test and repeated measurements ANOVA.

Effects of Thrower's Ten and Routine Physical Therapy in Patients With Shoulder Impingement Syndrome

To compare the effects of thrower's ten and routine physical therapy on pain, range of motion and functional disability in patients with shoulder impingement syndrome