Clinical Trial: Influence of Kinetic Chain Training on the Treatment Outcome of Overhead Athletes With Impingement

Study Status: Active, not recruiting
Recruit Status: Active, not recruiting
Study Type: Interventional

Official Title: Influence of Kinetic Chain Training on the Treatment Outcome of Overhead Athletes With Shoulder Impingement Syndrome

Brief Summary: A randomized controlled trial will be conducted to examine the effectiveness of a traditional home exercise program versus 2 kinetic chain home exercise programs on treatment outcome of overhead athletes with shoulder impingement syndrome. Primary outcome measures are reduction of pain and disability, and improvement in functionality and sports performance. Secondary outcome measures are strength, mobility, flexibility and functional performance.

Detailed Summary:

Participant are randomly assigned in 3 home exercise groups.

  1. The traditional program: consists of solely strengthening the rotator cuff muscles and scapular muscles (e.g. external rotation)
  2. Separate kinetic chain program: same exercises as the first group but they also receive an exercise program to separately train the core and lower body. (e.g. external rotation separately and squat separately)
  3. Integrated kinetic chain program: same exercises as the first group but all exercises are performed while simultaneously activating the kinetic chain. (e.g. external rotation while squatting).

Sponsor: University Ghent

Current Primary Outcome:

  • Changes in Shoulder Pain And Disability Index (SPADI) score [ Time Frame: At baseline and within one week after the 6-weeks training program ]
    Patients will fill in the SPADI questionnaire to evaluate shoulder pain and function. This questionnaire is a self-administered, shoulder-specific index consisting of 13 items, divided into two subscales, pain and function with responses to each item scored on a 10-point scale.
  • Changes in Western Ontario Shoulder Stability index (WOSI) score [ Time Frame: At baseline and within one week after the 6-weeks training program ]
    The WOSI is a patient-evaluated disease-specific quality of life scoring questionnaire that has been developed for shoulder instability patients. It consists of 21 items each scored on a 100mm Visual Analogue Scale (VAS). Each item falls into one of the domains of: Physical function, sports/recreation/work, lifestyle and emotional well-being. Each question is scored between 0-100 points and the summation of all the questions results in a final WOSI score. The final score ranges from 0 (best possible score - the patient is experiencing no decrease in shoulder related quality of life) to 2100 (worst score - signifies extreme distress in shoulder-related quality of life).
  • Return To Play (RTP) [ Time Frame: up to one week after the 6-weeks training program ]
    Is it possible to return to play after 6 weeks intervention or not? In addition, following question was asked: on a scale of 0 to 100%, what is the extent to which the injured shoulder has reached the shoulder function before the injury occurred?
  • Subjective perception of shoulde

    Original Primary Outcome:

    • Changes in Shoulder Pain And Disability Index (SPADI) score [ Time Frame: At baseline and within one week after the 6-weeks training program ]
      Patients will fill in the SPADI questionnaire to evaluate shoulder pain and function. This questionnaire is a self-administered, shoulder-specific index consisting of 13 items, divided into two subscales, pain and function with responses to each item scored on a 10-point scale.
    • Changes in Western Ontario Shoulder Stability index (WOSI) score [ Time Frame: At baseline and within one week after the 6-weeks training program ]
      The WOSI is a questionnaire
    • Return To Play (RTP) [ Time Frame: up to one week after the 6-weeks training program ]
    • Subjective perception of shoulder improvement [ Time Frame: 6-weeks training program ]
      Patients rated their subjective perception of improvement of their shoulder pain as ''improved,'' ''not changed'' or ''worse.'' If they selected ''improved'' or ''worse,'' the amount of change was scored on a 5-point scale (very little change, little change, some change, a large change, a very large change)


    Current Secondary Outcome:

    • Changes in shoulder muscle isokinetic strength (Biodex system 4) [ Time Frame: at baseline and within one week after the 6-weeks training program ]
      Isokinetic strength of shoulder internal and external rotators will be measured bilateral with the Biodex device (Biodex system 4, Biodex Medical Systems, Inc., Shirley, New York, USA)
    • Changes in shoulder scapular isokinetic strength [ Time Frame: at baseline and within one week after the 6-weeks training program ]
      Isokinetic strength of scapular protraction and retraction muscles will be measured bilateral with the Biodex device (Biodex system 4, Biodex Medical Systems, Inc., Shirley, New York, USA)
    • Changes in shoulder, hip and scapular mobility [ Time Frame: at baseline and within one week after the 6-weeks training program ]

      Device: digital inclinometer (ACUMAR digital inclinometer, ACU, 360°; Lafayette Instrument Company, Lafayette, IN) 2 trials will be recorded for each movement direction and for both sides:

      • Shoulder: external and internal rotation
      • Hip: external and internal rotation
      • Scapula: scapular upward rotation at 0°, 90° en 120° of elevation in the scapular plane.
    • Changes in posture [ Time Frame: at baseline and within one week after the 6-weeks training program ]
      Forward head posture using a digital camera and thoracic kyphosis using a digital inclinometer (ACUMAR digital inclinometer, ACU, 360°; Lafayette Instrument Company, Lafayette, IN).
    • Changes in scapular dyskinesis [ Time Frame: at baseline and within one week after the 6-weeks training program ]
      Scapular dyskinesis will be measured by observing the scapular movement during active elevation. For both sides (left and right), scapular dyskinesis was evaluated as being present or not. In case dyskinesis was present, the amount of dyskinesis is scored as subtle or prominent.
    • Changes in pectoralis minor resting length [ Time Frame: at baseline and within one week after the 6-weeks training program ]
      The length of the pectoralis minor will be determined by measuring the distance between 2 reference points using a digital caliper.
    • Changes in functional tests for upper and lower limb [ Time Frame: at baseline and within one week after the 6-weeks training program ]

      The following functional tests will be performed:

      • Seated medicine ball trow
      • Y balance test for upper limb
      • Y balance test for lower limb
      • A throwing related fatigue test
      • Vertical jump
      • Lateral to medial jump


    Original Secondary Outcome: Same as current

    Information By: University Ghent

    Dates:
    Date Received: September 29, 2015
    Date Started: September 2015
    Date Completion: September 2018
    Last Updated: May 4, 2017
    Last Verified: May 2017