Latissimus Dorsi Strengthening Exercises in Rotator Cuff Tendinopathy

NCT07053566 | Enrolling By Invitation

• 1 other identifier: LDRCT
• Study Type: interventional
• Target: 47
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to investigate the effects of strengthening exercises targeting the latissimus dorsi muscle on acromiohumeral distance, shoulder function, and pain levels in individuals with rotator cuff tendinopathy. By increasing the activation of the latissimus dorsi, one of the shoulder adductor muscles, the exercises are expected to facilitate inferior gliding of the humeral head and improve subacromial distance. Individuals aged between 18 and 50 years with a diagnosis of rotator cuff tendinopathy will be included in the study. A total of 47 participants will be enrolled and randomly assigned to one of three groups: A group performing exercises targeting only the rotator cuff muscles, A group performing exercises targeting the latissimus dorsi muscle, A group performing a combination of both rotator cuff and latissimus dorsi exercises. The exercise interventions will be applied over a 12-week period. Before and after the intervention, the following outcomes will be assessed: Acromiohumeral distance (via ultrasound), Range of motion, Shoulder function and pain using the SPADI and WORC questionnaires, and Avoidance behavior using the Adap-Tr questionnaire.

Conditions

Rotator Cuff Related Shoulder Pain; Rotator Cuff Tendinopathy; Subacromial Impingement Syndrome

Keywords

Exercise Theraphy; Shoulder Rehabilitation; Rotator Cuff; Latissimus Dorsi

Outcome Measures

Primary Outcomes (3)

• Acromio-humeral distance

  The acromiohumeral distance will be assessed using ultrasonography. Measurements will be performed by a physician blinded to the participants' group assignments, ensuring assessor blinding. Ultrasonographic measurement of the acromiohumeral distance has been shown to be reliable (intraclass correlation coefficient \> 0.90), and the minimal detectable change has been reported as 1.2 mm

  Measurements will be performed at baseline and at the end of the 12th week

• Pain İntensity

  Pain intensity will be assessed using the Visual Analog Scale (VAS) at rest, during activity, and at night. On the VAS, a score of 0 indicates no pain, while a score of 10 represents unbearable pain. Higher scores reflect greater pain intensity.he scale will be explained to the patient in a face-to-face setting, and they will be asked to mark their pain levels at rest, during activity, and at night on a 100-millimeter horizontal line.

  Baseline and weekly up to 12 weeks

• Shoulder Range of Motion

  ll measurements will be performed with the patient in the supine position. For shoulder flexion ROM, the patient will be asked to raise their arm upward in the sagittal plane. For shoulder abduction ROM, the patient will be instructed to move their arm laterally in the scapular plane.For external and internal rotation ROM measurements, the shoulder will be positioned at 90° of abduction and the elbow at 90° of flexion.For external rotation, the patient will be asked to move the forearm upward in the sagittal plane, with the palm facing toward themselves and in the direction of the thumb. For internal rotation, the patient will be asked to move the forearm downward in the sagittal plane, in the direction of the index finger.

  Baseline and weekly up to 12 weeks

Secondary Outcomes (3)

• ADAP-Shoulder Scale (Avoidance Behavior)

  Measurements will be performed at baseline and at the end of the 12th week.

• Shoulder Pain and Disability Index (SPADI)

  At baseline and at the end of Week 12

• Western Ontario Rotator Cuff Index (WORC)

  Measurements will be performed at baseline and at the end of the 12th week.

Study Arms (3)

Rotator Cuff Exercise Group (RCEG)

EXPERIMENTAL

Progressive strengthening program for rotator cuff muscles.

Behavioral: Rotator Cuff Strengthening Exercises

Latissimus Dorsi Exercise Group (LDEG)

EXPERIMENTAL

Progressive strengthening program for latissimus dorsi muscle.

Behavioral: Latissimus Dorsi Strengthening Exercises

Combined Exercise Group (CEG)

EXPERIMENTAL

Combined strengthening program for rotator cuff and latissimus dorsi muscles

Behavioral: Rotator Cuff Strengthening Exercises; Behavioral: Latissimus Dorsi Strengthening Exercises

Interventions

Rotator Cuff Strengthening Exercises BEHAVIORAL

Progressive exercise program focused on rotator cuff muscles

Combined Exercise Group (CEG); Rotator Cuff Exercise Group (RCEG)

Latissimus Dorsi Strengthening Exercises BEHAVIORAL

Progressive exercise program targeting the latissimus dorsi muscle

Combined Exercise Group (CEG); Latissimus Dorsi Exercise Group (LDEG)

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age between 18 and 50 years
• At least 3 months of ongoing shoulder pain
• At least 3 positive tests out of 5 (Neer, Hawkins-Kennedy, Jobe, Painful Arc Sign, Pain on Resisted External Rotation)
• Ultrasound diagnosis of rotator cuff tendinopathy
• Shoulder pain during activity rated greater than 3 out of 10 on the Numeric Pain Scale
• Central Sensitization Inventory score below 40

You may not qualify if:

• Bilateral shoulder pain
• History of surgery or dislocation in the symptomatic shoulder
• Acromioclavicular degeneration
• Presence of shoulder capsulitis (restriction in passive glenohumeral range of motion in 2 or more directions)
• Full-thickness rotator cuff tear
• Shoulder osteoarthritis, rheumatoid arthritis, systemic inflammatory or neurological disease
• Any injection to the symptomatic shoulder within the past 6 weeks
• BMI greater than 30 kg/m2
• Refusal to participate in the study

Sponsors & Collaborators

• Hacettepe University: lead

Study Sites (1)

Hacettepe University Faculty of Physical Therapy and Rehabilitation

Ankara, 06000, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Shoulder Impingement Syndrome

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Masking Details: In this study, both the participants and the investigator (physician) are blinded to the group assignments.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor and Principal Investigator

Model Details: Randomized Controlled Trial

Study Record Dates

• First Submitted: June 18, 2025
• First Posted: July 8, 2025
• Study Start: May 23, 2025
• Primary Completion (Estimated): May 22, 2027
• Study Completion (Estimated): September 22, 2027
• Last Updated: September 15, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)