Effects of Kinetic Chain Exercises on Pain, Range of Motion and Disability in Shoulder Impingement Syndrome

Riphah International University36 enrolled

Overview

PROJECT SUMMARY Shoulder pain is secondary only to lower back pain in occurrence. Impingement is one of the most common shoulder disorders. The aim of this study is to evaluate the effects of kinetic chain exercises on pain, ROM and disability in patients with shoulder impingement syndrome which is important in establishing eveidence for a holistic and potentially more effective rehabilitation method for shoulder impingement syndrome. This study will be a randomized control trial and will be conducted in Riphah International University associated hospital and physiotherapy outpatient department of Jinnah hospital Lahore. Non probability consecutive sampling will be used. Sample size of 32 subjects with age group 30 to 50 years will be taken. Data will be collected from patients having present complaint of shoulder pain due to shoulder impingement. Outcome measures will be taken using numeric pain rating scale(NPRS) for pain, universal Goniometer for ROM and Shoulder pain and disability index (SPADI) for function. An informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria and will be equally divided into two groups. Group A will receive kinetic chain exercises (both open and closed chain exercises) and group B will receive conventional physical therapy treatment. Data analysis will be done by SPSS version 28

Interventions

Kinetic chain exercisesOTHER

Kinetic chain exercises work on the stabilizer muscles of scapula, such as the anterior serratus, rhomboids, and trapezius, which are responsible for maintaining the scapula-humeral rhythm. These scapular stabilizers reduce the undesirable movements that would otherwise cause shoulder impingement, therefore reducing stress on the sub-acromial structures. Kinetic chain exercises enhance body's proper movement patterns, improving proprioception, and increase the activation of primary movers. Decreased biomechanical dysfunction results in better arm positioning. By performing exercises that address the entire kinetic chain, these would assist in avoiding the compensatory mechanisms and repetitive strain injuries that act as relapse triggers for SIS. The patients enjoy sustained relief from shoulder impingement syndrome pain and notice less frequency of future shoulder injuries Kinetic chain shoulder therapy exercises involve kinetic link and model called biomechanical model and cranial t

conventional physical therapy treatmentOTHER

* Heating pad for ten minutes * Therapeutic ultrasound for 5 minutes * Active range of motion exercises (two sets of 15 repetitions for each exercise) * Codman exercises (two sets of 15 repetitions)

Eligibility

Sex: ALLMin age: 30 YearsMax age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * • Age group 30-50 years * Males and Females * Subjects with history of pain in upper lateral aspect of arm with a NPRS score between \>3 to \<8 on a 0-10 scale * Neers impingement test positive * Hawkins- Kennedy test positive * Painful arc positive * Empty can (Jobe test) positive Exclusion Criteria: * • Subjects having Capsular Pattern +ve * Individuals with OA of GH joint * Type III acromion process decreasing the sub-acromial space leading to sub-acromial impingement (on X-ray evaluation) * AC joint arthritis * Rheumatoid Arthritis * Fracture history involving upper limb * Shoulder surgery on affected side. * Subjects with signs of total rotator cuff tears i.e. gross weakness in abduction. * Subjects who received corticosteroid injections in last three months

Outcomes

Primary Outcomes

Numeric Pain Rating scale

. This scale ranges from 0 to 10 where 0 indicating "no pain" and 10 indicating "worst pain possible"

Time frame: from start of study to 4 weeks

Shoulder Pain and Disability Index

The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire that consisting of two dimensions, one for the pain and other for functional ability of the subject. The pain dimension consists of five questions regarding the severity of an individual's pain intensity

Time frame: From start of study upto 4 weeks

Universal Goniometer

Health care practitioners often use universal goniometer to obtain objective measurements of joint range of motion (ROM) to find out the baseline functional status and to measure the effectiveness of treatment interventions