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IRCT20230526058291N1 IRCT 2023-08-12 The University of Lahore, Lahore Pakistan Effects of manual therapy in addition to stretching and strengthening exercises in patients with shoulder impingement syndrome Effects of manual therapy in addition to stretching and strengthening exercises to improve scapular range of motion, functional capacity and pain in patients with shoulder impingement syndrome 2022-03-09 anticipated 36 Complete https://irct.ir/trial/70401 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: In this study, a total of 36 participants were enrolled, and they were assigned to two treatment groups using computer-generated randomization. Simple randomization process was performed using Microsoft Excel which is a computer-based random number generator . Each participant received a unique identifier, and a sequence of 36 random numbers was generated by the computer. These random numbers were then used to allocate participants to either Group A or Group B.Group A consisted of participants who received manual therapy along with stretching and strengthening exercises. On the other hand, Group B included participants who received only the stretching and strengthening exercises without manual therapy. Unit of randomization was individual.The utilization of computer-generated randomization ensured that the assignment of participants to treatment groups was unbiased and fair. To further eliminate biasness, researchers also employed the concealed envelope method. For each participant, a sealed envelope was prepared, containing the information about which group (Group A or Group B) the participant would be assigned to, Blinding description: This was a single blinded study in which It is difficult to blind patients and therapists so only the assessor who was also a health care provider was kept blinded due to treatment regime. It is believed that while measuring effectiveness of an intervention, it is difficult to blind patients and therapists, so, outcome assessor blinding is done. N/A Shoulder Impingement Syndrome. Intervention 1: Group A (Intervention group): Group A was treated with exercises and 45 minutes of manual therapy session was given to each patient. The participants were assessed within a week before intervention (pre-intervention) and the end of the 4 week intervention (post-intervention). Patient got 3 sessions per week.The total duration of intervention was 1 month. Manual therapy was employed only at the involved side. The grade lll and lV mobilization were performed including arthrokinematic movements for different sub-joints at the shoulder such as glenohumeral, scapulothoracic, sternoclavicular and acromioclavicular joints and cervical spine as well.The manual therapy was applied by a certified physical therapist according to each patient’s need. Intervention 2: Control group: Group B was given only strengthening and stretching exercises for both involved and uninvolved sides. The upper trapezious, the pectoralis minor and the posterior part of the shoulder were targeted for the stretching and strengthening. For strengthening of the muscles, exercises were performed with an external rotation of the shoulder, initiating with elbow flexion at 90° in the scapular plane. Shoulder extension in prone position was performed for the lower trapezious muscle.For pectoralis minor, wall push-ups were instructed to the participants. The frequency of each exercise was 5x3 initially that was progressed later.Frequency of intervention : Number of sessions 3 per week for 4 weeks. Interval: session lasted for 25-30mins with rest interval of 1 minute. The total duration of intervention was 1 month. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is This study may or may not be available for other researchers. It may e available for just physiotherapists
public Sana Tauqeer
1-Km Defence Road،, near Bhuptian Chowk،, Lahore, Punjab
Lahore Pakistan 5400 +92 324 4294807 sana.tauqeer@uipt.uol.edu.pk The University of Lahore, Lahore Pakistan scientific Sana Tauqeer
1-Km Defence Road،, near Bhuptian Chowk،, Lahore, Punjab
Lahore Pakistan 5400 +92 324 4294807 sana.tauqeer@uipt.uol.edu.pk The University of Lahore, Lahore Pakistan Pakistan Shoulder Impingement Syndrome from more than 3 months Non Traumatic Onset of Shoulder Pain Painful Arc is Positive One or More Shoulder Impingement Test is positive Pain during passive or isometric resisted external rotation of the arm at 90 degree of abduction 25 years 40 years Both Fracture (clavicle, humerus or scapular) Numbness and Tingling Sensation in Upper limb after Cervical Compression Test Sulcus test is positive Positive drop arm test is positive systematic illness M75.4 Impingement syndrome of shoulder Treatment - Other Rehabilitation Group A (Intervention group): Group A was treated with exercises and 45 minutes of manual therapy session was given to each patient. The participants were assessed within a week before intervention (pre-intervention) and the end of the 4 week intervention (post-intervention). Patient got 3 sessions per week.The total duration of intervention was 1 month. Manual therapy was employed only at the involved side. The grade lll and lV mobilization were performed including arthrokinematic movements for different sub-joints at the shoulder such as glenohumeral, scapulothoracic, sternoclavicular and acromioclavicular joints and cervical spine as well.The manual therapy was applied by a certified physical therapist according to each patient’s need. Control group: Group B was given only strengthening and stretching exercises for both involved and uninvolved sides. The upper trapezious, the pectoralis minor and the posterior part of the shoulder were targeted for the stretching and strengthening. For strengthening of the muscles, exercises were performed with an external rotation of the shoulder, initiating with elbow flexion at 90° in the scapular plane. Shoulder extension in prone position was performed for the lower trapezious muscle.For pectoralis minor, wall push-ups were instructed to the participants. The frequency of each exercise was 5x3 initially that was progressed later.Frequency of intervention : Number of sessions 3 per week for 4 weeks. Interval: session lasted for 25-30mins with rest interval of 1 minute. The total duration of intervention was 1 month Pain. Timepoint: Pain was measured with in the week before treatment and at the end of 4 week intervention. Method of measurement: Numeric Pain Rating Scale(NPRS). Functional Capacity. Timepoint: Functional Capacity was measured with in the week before treatment and at the end of 4 week intervention. Method of measurement: DASH(Disability of Hand, Shoulder and Arm Questionnaire). Scapular Range of Motion (scapular protraction and upward rotation. ). Timepoint: Scapular Ranges was measured with in the week before treatment and at the end of 4 week intervention. Method of measurement: Goniometer was used to measure Scapular Ranges. The University of Lahore, Lahore Pakistan Approved 2022-01-12 Ethics Committee of The University of Lahore, Lahore Pakistan 1-Km Defence Road،, near Bhuptian Chowk،, Lahore, Punjab Lahore Punjab Pakistan