The purpose of this study is to investigate and compare the effect of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit. Isolytic group will receive isolytic stretching in modified cross body stretching position and standard physiotherapy program. Static group will receive static stretching in modified cross body stretching position and standard physiotherapy program. Control group will receive only standard physiotherapy program.
The effectiveness of static stretching on various parameters such as range of motion or pain is studied and proved in literature. Static stretching in cross body position was also found helpful for improving shoulder range of motion with some disadvantages. In modified cross body position, the patient is positioned in a more advantageous way for him/her. Usually this stretching is done as active-assistive static stretching with the physiotherapist. Proof is still needed for the effectiveness of active-assistive static stretching in modified cross body position. Furthermore, there is no research about the effect of isolytic stretching which is relatively new technique compare to static stretches in subacromial impingement syndrome. In isolytic stretching, when the patient contracts the agonist muscle group with 20% muscle force active-assistive streching in agonist muscle group by the physiotherapist at the same time is done for 2-4 seconds. A fast isolytic stretching is applied in order to break the fibrous tissue. Our purpose is to investigate and compare the effect of isolytic and static stretching training in individuals having subacromial impingement syndrome with glenohumeral internal rotation deficit . Stretching groups will receive either isolytic or static stretching in modified cross body stretching position and standard physiotherapy program. There is a control group. Control group will receive only standard physiotherapy program. Standard physiotherapy program includes TENS, hotpack, posture and strengthening training program. Treatment program will last four times a week (4-4-4-3) for four weeks, 15 sessions in total.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
In modified cross body position, isolytic stretching exercises will perform five times each for 15 seconds. After each stretching patient will rest for 5 seconds. When the patient contracts the agonist muscle group with 20% muscle force, the agonist muscle group is stretched at the same time for 2-4 seconds. Isolytic stretching exercises will perform four times a week for four weeks. It's obligatory to receive at least 15 sessions in total. They will also receive standard physiotherapy program four times a week for four week, 15 sessions in total.
In modified cross body position, active-assistive static stretching exercises will be performed 5 times each for 15 seconds. This stretching exercise is performed 5 times with 5 seconds intervals. Static stretching exercises will perform four times a week for four weeks. It's obligatory to receive at least 15 sessions in total. They will also receive standard physiotherapy program four times a week for four week, 15 sessions in total.
Dokuz Eylül University
Izmir, Balçova, Turkey (Türkiye)
Shoulder internal rotation range of motion
Change of shoulder internal rotation range of motion (with bubble inclinometer)
Time frame: Baseline and 4 weeks
Glenohumeral internal rotation deficit
Change of difference in shoulder internal rotation range of motion between the affected and non-affected shoulder (with bubble inclinometer)
Time frame: Baseline and 4 weeks
Posterior shoulder tightness
Change of posterior shoulder tightness (with bubble inclinometer)
Time frame: Baseline and 4 weeks
Shoulder external rotation range of motion
Change of shoulder external rotation range of motion (with bubble inclinometer)
Time frame: Baseline and 4 weeks
Shoulder total rotational range of motion
Change of shoulder total rotational range of motion (Sum of the internal and external rotation motion)
Time frame: Baseline and 4 weeks
Resting and activitiy pain in shoulder
Change of visual analog scale score in activity and rest pain
Time frame: Baseline and 4 weeks
Subacromial space
Change of subacromial space at arm resting at the side (0°), and at 60° of scapular plane elevation (with Ultrasound)
Time frame: Baseline and 4 weeks
Supraspinatus tendon thickness
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Masking
SINGLE
Enrollment
70
They will receive only standard physiotherapy program, four times a week for four weeks, 15 sessions in total.
Change of supraspinatus tendon thickness (with Ultrasound)
Time frame: Baseline and 4 weeks
Concentric strength
Change of rotattor cuff muscles concentric strength (in kg, with hand held dynamometer)
Time frame: Baseline and 4 weeks
Eccentric strength
Change of shoulder abduction eccentric strength (in kg, with hand held dynamometer)
Time frame: Baseline and 4 weeks
Shoulder Function
Change of Modified Constant-Murley Score
Time frame: Baseline and 4 weeks
Upper extremity function
Change of disabilities of the arm, shoulder, and hand (Quick-DASH) score
Time frame: Baseline and 4 weeks