Comparative Effects of Two Procedures for the Management of Posterior Shoulder Tightness

NCT05128448 | Unknown

• 1 other identifier: FACCAT
• Study Type: interventional
• Target: 22
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare the effects of a self-stretch procedures versus a clinician applied musculoskeletal procedure in individuals with posterior shoulder tightness.

Conditions

Posterior Shoulder Tightness

Outcome Measures

Primary Outcomes (2)

• Horizontal adduction

  Horizontal adduction in 90 degrees of shoulder flexion

  change immediately after the intervention

• Internal rotation

  Internal rotation at 90 degrees of shoulder abduction

  change immediately after the intervention

Secondary Outcomes (1)

• Mechanical sensitivity

  change immediately after the intervention

Study Arms (2)

Mobilisation with movement (MWM)

EXPERIMENTAL

With the participant standing, the restricted shoulder will rest on the clinician's shoulder in the following starting position: 90 degrees of glenohumeral abduction and 90 degrees of elbow flexion and hand holding a treatment belt. The belt will loop around the clinician and patient and will be held by the participant's contralateral hand. The clinician will apply and sustain a pain free caudal or posterolateralcaudal humeral head mobilisation force (whichever is more comfortable to the subject), followed by an active internal rotation (IR) performed by the patient. The IR movement will be performed to a pain free end of range. If possible, an overpressure with be requested, this is achieved by pulling the belt with the contralateral hand. The overpressure should not produce pain, if it does, it will not be performed. 3 sets of 8 repetitions will be applied, sustaining the end of available range for 2 seconds. An interval of 45 seconds will be respected amongst the repetitions.

Other: Mobilisation with movement (MWM)

Cross-body stretch

ACTIVE COMPARATOR

With the participant standing, the restricted shoulder will be self-stretched by conducting a horizontal adduction in 90 degrees of shoulder flexion to a level tolerated by the participant. This position will be held for thirty seconds and repeated four times. An interval of forty five seconds will be respected amongst the repetitions.

Other: Cross-body stretch (CBS)

Interventions

Cross-body stretch (CBS) OTHER

CBS is a self administered stretch that aims to stretch posterior shoulder structures

Cross-body stretch

Mobilisation with movement (MWM) OTHER

WMW is a musculoskeletal procedure that aims to improve restricted and/or painful range of movement

Mobilisation with movement (MWM)

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Asymptomatic individuals without any history of shoulder pain necessitating medical attention.
• Presence of unilateral restriction of at least 10 degrees of internal rotation deficit during the internal rotation mobility test in 90 degrees of shoulder abduction.

You may not qualify if:

• Asymptomatic individuals that present with shoulder pain on the assessment day.
• Individuals with chronic conditions not affecting the shoulder.
• Individuals with clinical depression.
• Individuals that used analgesic and/or anti-inflammatory medication in the previous 24 hours of assessment.
• Individuals with fibromialgia.
• Individuals engaged in overhead sports.

Sponsors & Collaborators

• Federal University of Health Science of Porto Alegre: lead

Study Sites (1)

Faculdades Integradas de Taquara

Taquara, Rio Grande do Sul, 95612-150, Brazil

Location

Related Publications (12)

• Picavet HS, Schouten JS. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain. 2003 Mar;102(1-2):167-78. doi: 10.1016/s0304-3959(02)00372-x.

  PMID: 12620608 BACKGROUND

• Hall K, Borstad JD. Posterior Shoulder Tightness: To Treat or Not to Treat? J Orthop Sports Phys Ther. 2018 Mar;48(3):133-136. doi: 10.2519/jospt.2018.0605.

  PMID: 29490601 BACKGROUND

• Schwartz C, Croisier JL, Bruls O, Denoel V, Forthomme B. Tight shoulders: A clinical, kinematic and strength comparison of symptomatic and asymptomatic male overhead athletes before and after stretching. Eur J Sport Sci. 2021 May;21(5):781-791. doi: 10.1080/17461391.2020.1785015. Epub 2020 Jul 7.

  PMID: 32635824 BACKGROUND

• Rosa DP, Borstad JD, Ferreira JK, Camargo PR. The Influence of Glenohumeral Joint Posterior Capsule Tightness and Impingement Symptoms on Shoulder Impairments and Kinematics. Phys Ther. 2019 Jul 1;99(7):870-881. doi: 10.1093/ptj/pzz052.

  PMID: 30921461 BACKGROUND

• Tyler TF, Nicholas SJ, Lee SJ, Mullaney M, McHugh MP. Correction of posterior shoulder tightness is associated with symptom resolution in patients with internal impingement. Am J Sports Med. 2010 Jan;38(1):114-9. doi: 10.1177/0363546509346050. Epub 2009 Dec 4.

  PMID: 19966099 BACKGROUND

• Salamh PA, Kolber MJ, Hegedus EJ, Cook CE. The efficacy of stretching exercises to reduce posterior shoulder tightness acutely in the postoperative population: a single blinded randomized controlled trial. Physiother Theory Pract. 2018 Feb;34(2):111-120. doi: 10.1080/09593985.2017.1376020. Epub 2017 Sep 13.

  PMID: 28901811 BACKGROUND

• Salamh PA, Liu X, Kolber MJ, Hanney WJ, Hegedus EJ. The reliability, validity, and methodologic quality of measurements used to quantify posterior shoulder tightness: a systematic review of the literature with meta-analysis. J Shoulder Elbow Surg. 2019 Jan;28(1):178-185. doi: 10.1016/j.jse.2018.07.013. Epub 2018 Oct 1.

  PMID: 30287146 BACKGROUND

• Mine K, Nakayama T, Milanese S, Grimmer K. Effectiveness of Stretching on Posterior Shoulder Tightness and Glenohumeral Internal-Rotation Deficit: A Systematic Review of Randomized Controlled Trials. J Sport Rehabil. 2017 Jul;26(4):294-305. doi: 10.1123/jsr.2015-0172. Epub 2016 Aug 24.

  PMID: 27632891 BACKGROUND

• Salamh PA, Liu X, Hanney WJ, Sprague PA, Kolber MJ. The efficacy and fidelity of clinical interventions used to reduce posterior shoulder tightness: a systematic review with meta-analysis. J Shoulder Elbow Surg. 2019 Jun;28(6):1204-1213. doi: 10.1016/j.jse.2018.12.006. Epub 2019 Mar 20.

  PMID: 30902594 BACKGROUND

• Kang MH, Oh JS. Effects of self-stretching with mobilization on shoulder range of motion in individuals with glenohumeral internal rotation deficits: a randomized controlled trial. J Shoulder Elbow Surg. 2020 Jan;29(1):36-43. doi: 10.1016/j.jse.2019.08.007. Epub 2019 Oct 15.

  PMID: 31627965 BACKGROUND

• Hall K, Lewis J, Moore A, Ridehalgh C. Posterior shoulder tightness; an intersession reliability study of 3 clinical tests. Arch Physiother. 2020 Jul 29;10:14. doi: 10.1186/s40945-020-00084-w. eCollection 2020.

  PMID: 32742721 BACKGROUND

• Oliveira VMA, Pitangui ACR, Gomes MRA, Silva HAD, Passos MHPD, Araujo RC. Shoulder pain in adolescent athletes: prevalence, associated factors and its influence on upper limb function. Braz J Phys Ther. 2017 Mar-Apr;21(2):107-113. doi: 10.1016/j.bjpt.2017.03.005. Epub 2017 Mar 17.

  PMID: 28460708 RESULT

MeSH Terms

Interventions

Movement

Intervention Hierarchy (Ancestors)

Physiological Phenomena; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Marcelo Faria Silva, PhD

  Federal University of Health Science of Porto Alegre

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: All measurements will be conducted by research assistants unaware of the interventions applied. Statistical analyses will be performed by a blinded research assistant.
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: October 17, 2021
• First Posted: November 22, 2021
• Study Start: October 17, 2021
• Primary Completion: December 20, 2021
• Study Completion: February 28, 2022
• Last Updated: November 22, 2021

Record last verified: 2021-11

Locations

BR (1)