Graded Motor Imagery Training in Shoulder Impingement Syndrome

NCT06081088 | Completed DMC

• 1 other identifier: Marmara Uni.
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to investigate the effects of Graded Motor Imagery (GMI) training on pain, functionality, disability and daily living activities in patients diagnosed with Shoulder Impingement Syndrome.

Conditions

Shoulder Impingement Syndrome; Pain

Keywords

Shoulder Impingement Syndrome; Mirror Neurons; Pain; Functional Status; Rehabilitation

Outcome Measures

Primary Outcomes (2)

• Pain intensity

  Pain intensity will be assessed with Visual Analog Scale (VAS). The VAS is usually a horizontal line, 10 cm in length, anchored by word descriptors at each end with "No Pain" (score of zero) on the left side up to "pain as bad as it could be" or the "worst imaginable pain" (Score of 100 \[100-mm scale\]) on the right side.The patient will be asked to mark the line point that represented his or her current pain.

  Baseline, Interim evaluation (At the end of the 3rd week), After the six-week intervention, After six-weeks of follow-up

• Functional Status

  The disabilities of the Arm, Shoulder and Hand (DASH) questionnaire will be used in shoulder functional status evaluation. The DASH consists mainly of a 30-item disability/symptom scale, scored 0 (no disability) to 100. 21 of the questions of the survey question the ability to perform functional activities, 5 question the pain, and 4 question the psychosocial effects of the disease. Each question is scored using a 5-point Likert scale ranging from 1 to 5 (1: no difficulty, 2: mild difficulty, 3: moderate difficulty, 4: extreme difficulty, 5: not at all). Higher scores indicate better functional status.

  Baseline, Interim evaluation (At the end of the 3rd week), After the six-week intervention, After six-weeks of follow-up

Secondary Outcomes (6)

• Active Range Of Motion (AROM)

  Baseline, After the six-week intervention, After six-weeks of follow-up

• Isometric Muscle Strength

  Baseline, After the six-week intervention, After six-weeks of follow-up

• Functional Status Of the Hand

  Baseline, After the six-week intervention, After six-weeks of follow-up

• Left/right discrimination (Lateralization)

  Baseline, After the six-week intervention, After six-weeks of follow-up

• Kinesthetic and Visual Imagery Questionnaire (KVIQ)

  Baseline, After the six-week intervention, After six-weeks of follow-up

Study Arms (2)

Group 1

EXPERIMENTAL

Study group: "Graded Motor Imagery Training + Conventional Physiotherapy" In this group, each participant will be received a treatment protocol consisting of Graded Motor Imagery training, conventional physiotherapy, and home exercises. * Graded Motor Imagery (GMI) * Conventional Physiotherapy Program * Home Exercise Program

Other: Graded Motor Imagery (GMI) training; Other: Conventional Physiotherapy; Other: Home Exercise Program

Group 2

ACTIVE COMPARATOR

Control group: "Conventional Physiotherapy" In this group, each participant will be received a treatment protocol consisting of conventional physiotherapy, and home exercises. * Conventional Physiotherapy Program * Home Exercise Program

Other: Conventional Physiotherapy; Other: Home Exercise Program

Interventions

Graded Motor Imagery (GMI) training OTHER

GMI consists of three basic components: 1. Left / Right Discrimination training (Lateralization training): For lateralization training, patients will be trained by asking them to distinguish between right and left with images taken at various angles and positions in the RecogniseTM (NOI-Australia) applications (shoulder and hand sections) (In weeks 1 and 2). 2. Motor Imagery (Explicit Motor Imagery): At this stage, the participant will be asked to imagine doing various functional activities (brushing teeth, combing hair, etc.) in the position they feel most comfortable in and in a quiet environment (In weeks 2 and 3). 3. Mirror Therapy (providing visual feedback through a mirror): In this phase, active ROM exercises and progressive resistance exercises with simultaneous movement of the affected and unaffected extremities will be applied using a standard size posture mirror (In weeks 3-6). This program will be applied for 6 weeks (3 sessions per week).

Group 1

Conventional Physiotherapy OTHER

Conventional physiotherapy program includes passive, active-assistive (wand exercises) and active ROM exercises for shoulder joint, passive / active posterior and anterior capsule stretching exercises, superior-inferior, mediolateral and distraction techniques for scapular mobilization exercises, shoulder flexion, abduction, internal and external rotation muscles strengthening exercises, static and dynamic stabilization exercises for proprioception exercises. To reduce the pain that may occur after exercises, cold application and Transcutaneous Electrical Nerve Stimulation (TENS) will be applied to benefit from their analgesic effects. Cold application will be applied around the shoulder using a coldpack (gel pack) cold therapy for 15 minutes. Conventional TENS application around shoulder will be performed using a TENS device and four separate 2 × 2 inch self-adhesive electrodes for 15 minutes.This program will be applied for 6 weeks (3 sessions per week).

Group 1; Group 2

Home Exercise Program OTHER

The home exercises program includes shoulder jonit active ROM exercises, active posterior and anterior shoulder capsule stretching exercises, shoulder flexion, abduction, internal and external rotation muscles strengthening exercises, shoulder proprioception exercises, and cold therapy. This program will be applied for 6 weeks (3 sessions per week).

Group 1; Group 2

Eligibility Criteria

• Age: 25 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged between 25-65 years old,
• Having been diagnosed with Shoulder Impingement Syndrome by physical examination and MRI as a result of shoulder pain lasting at least 3 months,
• Presence of a painful arc between 60° and 120° in shoulder flexion / abduction (elevation) movements,
• The Standardized Mini Mental Test result must be at least 24 points,
• Not having seen imagery practice before,

You may not qualify if:

• Having severe mental and communication problems,
• Having undergone surgical treatment on the same upper extremity,
• Presence of acute trauma, peripheral nervous system lesion, fracture or complete tendon rupture in the affected shoulder,
• Presence of other pathologies such as adhesive capsulitis of the shoulder joint complex and glenohumeral instability,
• Presence of radiotherapy history on the same side as the affected shoulder,
• Presence of congenital deformity,
• Symptomatic cervical spine pathology,
• Presence of other neurological or rheumatological disorders affecting upper motor function,
• Having any chronic disease that would prevent participation in the treatment program,
• Having attended a physiotherapy program within the last month.

Sponsors & Collaborators

• Marmara University: lead

Study Sites (1)

Marmara University

Istanbul, Başıbüyük, Süreyyapaşa Başıbüyük Yolu Sk No:4/B, 34854 Maltepe, 34854, Turkey (Türkiye)

Location

Related Publications (4)

• Araya-Quintanilla F, Gutierrez-Espinoza H, Jesus Munoz-Yanez M, Rubio-Oyarzun D, Cavero-Redondo I, Martinez-Vizcaino V, Alvarez-Bueno C. The Short-term Effect of Graded Motor Imagery on the Affective Components of Pain in Subjects with Chronic Shoulder Pain Syndrome: Open-Label Single-Arm Prospective Study. Pain Med. 2020 Oct 1;21(10):2496-2501. doi: 10.1093/pm/pnz364.

  PMID: 32003812 BACKGROUND

• Sawyer EE, McDevitt AW, Louw A, Puentedura EJ, Mintken PE. Use of Pain Neuroscience Education, Tactile Discrimination, and Graded Motor Imagery in an Individual With Frozen Shoulder. J Orthop Sports Phys Ther. 2018 Mar;48(3):174-184. doi: 10.2519/jospt.2018.7716. Epub 2017 Dec 19.

  PMID: 29257926 BACKGROUND

• Louw A, Puentedura EJ, Reese D, Parker P, Miller T, Mintken PE. Immediate Effects of Mirror Therapy in Patients With Shoulder Pain and Decreased Range of Motion. Arch Phys Med Rehabil. 2017 Oct;98(10):1941-1947. doi: 10.1016/j.apmr.2017.03.031. Epub 2017 May 5.

  PMID: 28483657 BACKGROUND

• Moseley GL. Graded motor imagery for pathologic pain: a randomized controlled trial. Neurology. 2006 Dec 26;67(12):2129-34. doi: 10.1212/01.wnl.0000249112.56935.32. Epub 2006 Nov 2.

  PMID: 17082465 BACKGROUND

MeSH Terms

Conditions

Shoulder Impingement Syndrome; Pain

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• MASOUD AMIR RASHEDI BONAB, PhD

  Marmara University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 2, 2023
• First Posted: October 12, 2023
• Study Start: October 16, 2023
• Primary Completion: June 27, 2024
• Study Completion: June 27, 2024
• Last Updated: June 28, 2024

Record last verified: 2023-10

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)