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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
Subjects will learn how to control their scapula during motor control exercise with application of dynamic tape
Subjects will learn how to control their scapula during motor control exercise without taping
National Yang Ming Chiao Tung University
Taipei, Taiwan, Taiwan
Neurophysiological measures - Active motor threshold
Active motor threshold (AMT) will be described with the percentage (%) of maximum stimulator output (MSO).
Time frame: Change from baseline AMT at the completion of the first 30-minute intervention
Neurophysiological measures - Active motor threshold
Active motor threshold (AMT) will be described with the percentage (%) of maximum stimulator output (MSO).
Time frame: Change from baseline AMT at the completion of 5-session intervention, an average of 2 weeks
Neurophysiological measures - Motor evoked potential
Motor evoked potential (MEP) will be described with millivolt (mV).
Time frame: Change from baseline MEP at the completion of the first 30-minute intervention
Neurophysiological measures - Motor evoked potential
Motor evoked potential (MEP) will be described with millivolt (mV).
Time frame: Change from baseline MEP at the completion of 5-session intervention, an average of 2 weeks
Neurophysiological measures - Cortical silent period
Cortical silent period (CSP) will be measured with millisecond (ms).
Time frame: Change from baseline CSP at the completion of the first 30-minute intervention
Neurophysiological measures - Cortical silent period
Cortical silent period (CSP) will be measured with millisecond (ms).
Time frame: Change from baseline CSP at the completion of 5-session intervention, an average of 2 weeks
Neurophysiological measures - Short interval cortical inhibition
Short interval cortical inhibition (SICI) will be defined as percentage (%) of conditioning responses vs testing responses while the inter-stimulus interval is below 5 ms
Time frame: Change from baseline SICI at the completion of the first 30-minute intervention
Neurophysiological measures - Short interval cortical inhibition
Short interval cortical inhibition (SICI) will be defined as percentage (%) of conditioning responses vs testing responses while the inter-stimulus interval is below 5 ms
Time frame: Change from baseline SICI at the completion of 5-session intervention, an average of 2 weeks
Neurophysiological measures - Short interval cortical facilitation
Short interval cortical facilitation (SICF) will be defined as percentage (%) of conditioning responses vs testing responses while the inter-stimulus interval is above 5 ms
Time frame: Change from baseline SICF at the completion of the first 30-minute intervention
Neurophysiological measures - Short interval cortical facilitation
Short interval cortical facilitation (SICF) will be defined as percentage (%) of conditioning responses vs testing responses while the inter-stimulus interval is above 5 ms
Time frame: Change from baseline SICF at the completion of 5-session intervention, an average of 2 weeks
Scapular kinematics
Scapular kinematics, including anterior/posterior tilt, upward/downward rotation, and internal/external rotation in scapula plan elevation at 30°, 60°, 90°, and 120°, will be calculated and will be described with degree (°).
Time frame: Change from baseline scapular kinematics at the completion of the first 30-minute intervention
Scapular kinematics
Scapular kinematics, including anterior/posterior tilt, upward/downward rotation, and internal/external rotation in scapula plan elevation at 30°, 60°, 90°, and 120°, will be calculated and will be described with degree (°).
Time frame: Change from baseline scapular kinematics at the completion of 5-session intervention, an average of 2 weeks
Scapular muscles activation
The root mean square of electromyography (EMG) data of the upper trapezius, lower trapezius, and serratus anterior will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %) and calculated over three 30° increments of motion during arm elevation from 30° to 120°, including 30° - 60°, 60° - 90°, and 90° - 120°
Time frame: Change from baseline scapular muscles activation at the completion of the first 30-minute intervention
Scapular muscles activation
The root mean square of electromyography (EMG) data of the upper trapezius, lower trapezius, and serratus anterior will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %) and calculated over three 30° increments of motion during arm elevation from 30° to 120°, including 30° - 60°, 60° - 90°, and 90° - 120°
Time frame: Change from baseline scapular muscles activation at the completion of 5-session intervention, an average of 2 weeks
Shoulder function
Shoulder function will be measured by the disabilities of the arm, shoulder and hand (DASH) questionnaire, including the disability/symptom section (30 items, scored 1-5) and the optional high performance Sport/Music or Work section (4 items, scored 1-5). A higher score indicates greater disability.
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Time frame: Change from baseline DASH questionnaire at the completion of 5-session intervention, an average of 2 weeks
Visual analogue scale (VAS) of shoulder pain and instability
Shoulder pain and instability will be measured by visual analogue scale (VAS). Subjects need to mark the point that they feel represent their perception of their current state on a 10-cm line. Scores range from 0 (no symptom) to 100 (maximum symptom).
Time frame: Change from baseline visual analogue scale at the completion of 5-session intervention, an average of 2 weeks