Study aiming at determining the efficacy of eccentric versus concentric exercises for improving tendon biological characteristics, pain, and shoulder overall function for rotator cuff tendinopathy in patients with Rheumatoid arthritis (RA). Moreover, investigation the relationship between RA activity and the severity of rotator cuff tendinopathy. Patients will be randomly assigned into either concentric or eccentric exercise group. Randomizations will be done using computer random generated numbers.
Study aiming at determining the efficacy of eccentric versus concentric exercises for improving tendon biological characteristics, pain, and shoulder overall function for rotator cuff tendinopathy in patients with RA. Moreover, investigation the relationship between RA activity and the severity of rotator cuff tendinopathy. Patients will be randomizations using computer random generated numbers. patients will receive either eccentric or concentric exercises for internal, external rotators and abductors muscles All patient will do stretching for posterior capsule and pectoralis minor Tendon biological changes and subacromial space will be assessed using musculoskeletal ultrasonography Shoulder function will be assessed using SPADI (shoulder pain and disability index Pain will be assessed using Visual Analogue Scale (VAS) Rheumatoid arthritis disease activity will be assessed using Disease Activity Score-28 for Rheumatoid Arthritis with erythrocyte sedimentation rate (DAS 28 ESR) patient will be assessed at base-line and after finishing of the study
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
concentric exercises for rotator cuff. internal rotators, external rotators and abductors Patient will do 3 sets of 10 repetitions resistance will be personalized to each patients
Eccentric exercises exercises for rotator cuff internal rotators, external rotators and abductors Patient will do 3 sets of 10 repetitions resistance will be personalized to each patients
stretching exercise for posterior capsule and pectoralis minor each stretch will be done for 30 seconds and repeated 3 times
Badr University in Cairo (BUC)
Cairo, Egypt
Shoulder function
shoulder Pain and Disability Index (SPADI): It is a self-reported questionnaire evaluating the function of the shoulder.
Time frame: one month
tendon thickness, fibrillar pattern and echogenicity
tendon thickness, fibrillar pattern and echogenicity as measured Ultrasonography
Time frame: one month
subacromial space
shoulder subacromial space as measured by Ultrasonography
Time frame: one month
Pain measured by Visual analogue scale (VAS)
pain as measured by Visual analogue scale which a 10 cm scale marked at the beginning zero indicating no pain and 10 at the end indicating worst pain
Time frame: one month
ESR
Erythrocyte sedimentation rate
Time frame: one month
disease activity score 28 Erythrocyte sedimentation rate (DAS 28- ESR)
disease activity score 28 Erythrocyte sedimentation rate High disease activity is defined as a DAS 28 ESR\>5.1, moderate activity as a DAS 28 ESR between 3.2 and ≤5.1, low activity as a DAS 28 ESR between 3.2 and \>2.6, and remission as a DAS 28 ESR less than 2.6
Time frame: one month
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