Effects of Externally Focused Shoulder Stabilization Exercises on Individuals With Rotator Cuff Tendinopathy

NCT06702319 | Active Not Recruiting

• 1 other identifier: EXTERNALFOCUS
• Study Type: interventional
• Target: 69
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate the effectiveness of externally focused shoulder stabilization exercises on range of motion, pain, handgrip strength, and proprioception in patients with rotator cuff tendinopathy. For the study, 69 patients will be randomly divided into three groups: Home Program Group (HPG), Internal Focused Exercise Group (IFEG), and External Focused Exercise Group (EFEG). The treatment period for all three groups will be 6 weeks. Shoulder range of motion, pain, handgrip strength, joint position sense, and shoulder function (WORC and QuickDASH) of the three groups will be evaluated at baseline and after intervention. IFEG will do the exercises with a physiotherapist twice a week. During the exercise, the patient will be allowed to focus on the body parts while performing the movement. EFEG will do the exercises with a physiotherapist twice a week. The patient will be allowed to focus on a point outside the body, namely the effect of the movement, during the exercise. In the management of HPG patients will be provided with an exercise brochure. At the conclusion of the study, the three groups will be compared and evaluated using appropriate statistical analyses to assess the outcomes and determine any significant differences between them.

Conditions

Shoulder Pain; Rotator Cuff Tendinitis

Outcome Measures

Primary Outcomes (1)

• Quick Disabilities of Arm, Shoulder & Hand

  The Quick Disabilities of Arm, Shoulder \& Hand Index is used to measure upper extremity physical function. A Turkish validity and reliability study has been conducted. The scale includes 11 headings extracted from the long version. Each question consists of a 5-point scale. The total score is calculated with the formula \[(sum of n responses) /n-1\] ×25, where n= indicates the total number of questions answered. The total score varies between 0 (no disability) and 100 (severe disability). The final score is classified as; 0- 15: 'no problem', 16-40: 'problem but able to work', 40 and above: 'unable to work'.

  one day before the intervention and 6 weeks after

Secondary Outcomes (5)

• Shoulder Joint Range of Motion

  one day before the intervention and 6 weeks after

• Assessment of Shoulder Pain

  one day before the intervention and 6 weeks after

• Western Ontario Rotator Cuff (WORC) Index

  one day before the intervention and 6 weeks after

• Assessment of Hand Grip Strength:

  one day before the intervention and 6 weeks after

• Assessment of Joint Position Sense:

  one day before the intervention and 6 weeks after

Study Arms (3)

home exercise program

NO INTERVENTION

A total of at least 23 Participants will receive the home exercise program for 6 weeks.

internal focus exercise program

EXPERIMENTAL

A total of at least 23 Participants will receive the internal focus exercise program for 6 weeks.

Other: Exercise

external focus exercise program

EXPERIMENTAL

A total of at least 23 Participants will receive the external focus exercise program for 6 weeks.

Other: Exercise

Interventions

Exercise OTHER

Home exercises and home exercises with internal focus exercises or external focus exercises

external focus exercise program; internal focus exercise program

Eligibility Criteria

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

You may qualify if:

• Having a diagnosis of rotator cuff tendinopathy,
• Having sufficient cooperation to perform the exercises.

You may not qualify if:

• Having a neurological problem,
• Having a previous fracture in the shoulder region,
• Having undergone a relevant surgery in the past,
• Having any chronic illness that could prevent exercise (e.g., chronic heart failure, pacemaker, etc.),
• Having a systemic condition that could affect proprioception, such as diabetes, rheumatoid arthritis, ankylosing spondylitis, or advanced osteoarthritis,
• Having received a physiotherapy program targeting the neck and upper extremity within the last 3 months.

Sponsors & Collaborators

• Izmir Democracy University: lead
• Buca Seyfi Demirsoy State Hospital: collaborator

Study Sites (1)

Izmir Democracy University

Izmir, Turkey (Türkiye)

Location

Related Publications (16)

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  PMID: 20357791 BACKGROUND

• Kibler WB. Rehabilitation of rotator cuff tendinopathy. Clin Sports Med. 2003 Oct;22(4):837-47. doi: 10.1016/s0278-5919(03)00048-6.

  PMID: 14560550 BACKGROUND

• Arnocky SP, Lavagnino M, Egerbacher M. The Response of Tendon Cells to Changing Loads: Implications in the Etiopathogenesis of Tendinopathy. In: Woo L-Y, Renström AFH, Arnoczky SP, editors. Tendinopathy in athletes. Oxford, UK: Wiley online library; 2007. pp. 46-59.

  BACKGROUND

• Camargo PR, Alburquerque-Sendin F, Salvini TF. Eccentric training as a new approach for rotator cuff tendinopathy: Review and perspectives. World J Orthop. 2014 Nov 18;5(5):634-44. doi: 10.5312/wjo.v5.i5.634. eCollection 2014 Nov 18.

  PMID: 25405092 BACKGROUND

• Wulf G, Hoss M, Prinz W. Instructions for motor learning: differential effects of internal versus external focus of attention. J Mot Behav. 1998 Jun;30(2):169-79. doi: 10.1080/00222899809601334.

  PMID: 20037032 BACKGROUND

• Wulf G, Lewthwaite R. Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning. Psychon Bull Rev. 2016 Oct;23(5):1382-1414. doi: 10.3758/s13423-015-0999-9.

  PMID: 26833314 BACKGROUND

• Wulf G, Weigelt M, Poulter D, McNevin N. Attentional focus on suprapostural tasks affects balance learning. Q J Exp Psychol A. 2003 Oct;56(7):1191-211. doi: 10.1080/02724980343000062.

  PMID: 12959910 BACKGROUND

• Park SH, Yi CW, Shin JY, Ryu YU. Effects of external focus of attention on balance: a short review. J Phys Ther Sci. 2015 Dec;27(12):3929-31. doi: 10.1589/jpts.27.3929. Epub 2015 Dec 28.

  PMID: 26834382 BACKGROUND

• Castillo-Vejar L, Lizama-Fuentes M, Bascour-Sandoval C, Cuyul-Vasquez I. [Attentional focus instructions for therapeutic exercise in people with musculoskeletal disorders. A scoping review]. Rehabilitacion (Madr). 2022 Oct-Dec;56(4):344-352. doi: 10.1016/j.rh.2021.11.006. Epub 2022 Apr 22. Spanish.

  PMID: 35469643 BACKGROUND

• Lohse KR, Sherwood DE. Defining the focus of attention: effects of attention on perceived exertion and fatigue. Front Psychol. 2011 Nov 14;2:332. doi: 10.3389/fpsyg.2011.00332. eCollection 2011.

  PMID: 22102843 BACKGROUND

• Hayes JR, Sheedy JE, Stelmack JA, Heaney CA. Computer use, symptoms, and quality of life. Optom Vis Sci. 2007 Aug;84(8):738-44. doi: 10.1097/OPX.0b013e31812f7546.

  PMID: 17700327 RESULT

• Bertelsen TI. [Visual coordination- and accommodation disturbances and eye diseases as causes of headache]. Nord Med. 1978 Apr;93(3-4):57-8. No abstract available. Norwegian.

  PMID: 643521 RESULT

• El O, Bircan C, Gulbahar S, Demiral Y, Sahin E, Baydar M, Kizil R, Griffin S, Akalin E. The reliability and validity of the Turkish version of the Western Ontario Rotator Cuff Index. Rheumatol Int. 2006 Oct;26(12):1101-8. doi: 10.1007/s00296-006-0151-2. Epub 2006 Jun 24.

  PMID: 16799776 RESULT

• Kirkley A, Alvarez C, Griffin S. The development and evaluation of a disease-specific quality-of-life questionnaire for disorders of the rotator cuff: The Western Ontario Rotator Cuff Index. Clin J Sport Med. 2003 Mar;13(2):84-92. doi: 10.1097/00042752-200303000-00004.

  PMID: 12629425 RESULT

• Koldas Dogan S, Ay S, Evcik D, Baser O. Adaptation of Turkish version of the questionnaire Quick Disability of the Arm, Shoulder, and Hand (Quick DASH) in patients with carpal tunnel syndrome. Clin Rheumatol. 2011 Feb;30(2):185-91. doi: 10.1007/s10067-010-1470-y. Epub 2010 Apr 22.

  PMID: 20411289 RESULT

• Vafadar AK, Cote JN, Archambault PS. Interrater and Intrarater Reliability and Validity of 3 Measurement Methods for Shoulder-Position Sense. J Sport Rehabil. 2016 Feb 2;25(1):2014-0309. doi: 10.1123/jsr.2014-0309. Print 2016 Feb 1.

  PMID: 25962861 RESULT

MeSH Terms

Conditions

Shoulder Pain; Rotator Cuff Injuries

Interventions

Exercise

Condition Hierarchy (Ancestors)

Arthralgia; Joint Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Rupture; Wounds and Injuries; Shoulder Injuries; Tendon Injuries

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Onur Engin, Assist Prof

  Izmir Democracy 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: PRINCIPAL INVESTIGATOR
• PI Title: Prof. Dr.

Study Record Dates

• First Submitted: November 14, 2024
• First Posted: November 22, 2024
• Study Start: July 1, 2024
• Primary Completion: September 1, 2024
• Study Completion: December 15, 2025
• Last Updated: November 26, 2024

Record last verified: 2024-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)