The Influences of Subscapularis Lesion on Ultrasonography and Kinematics in Patients With Shoulder Impingement
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|ClinicalTrials.gov Identifier: NCT05371457|
Recruitment Status : Completed
First Posted : May 12, 2022
Last Update Posted : July 18, 2022
|Condition or disease|
|Shoulder Impingement Syndrome|
|Study Type :||Observational|
|Actual Enrollment :||40 participants|
|Official Title:||The Influences of Subscapularis Lesion on Ultrasonography and Scapular Kinematics in Patients With Shoulder Impingement Syndrome|
|Actual Study Start Date :||May 14, 2022|
|Actual Primary Completion Date :||June 15, 2022|
|Actual Study Completion Date :||July 15, 2022|
- Thickness of Coracohumeral Ligament (CHL) [ Time Frame: Baseline ]The T3300 ultrasound system (BenQ, Taipei, Taiwan) is a portable ultrasonography machine to collect thickness of CHL as well as CHD. B-mode US depicts the CHL as a linear hyperechoic band surrounded by hyperechoic fat. Differentiation of the CHL from surrounding tissues can be achieved by tilting the probe to show anisotropy and by dynamic examination IR and ER. The CHL will be loosened (concave) in IR and tightened (straight) in ER. During the maximal ER, the thickness of the CHL at a 2-mm distance from the coracoid process will be measured.
- Coracohumeral Distance (CHD) [ Time Frame: Baseline ]CHD was measured with the probe positioned on the lateral border of the coracoid process to obtain images of the coracoid process and humeral head in 4 different shoulder rotation positions: (1) shoulder neutral rotation (CHD-NR), (2) external rotation (CHD-ER) and (3) shoulder internal rotation with maximal forward flexion and full adduction (CHD-IRFA, with the arm adducted across the chest reaching for the opposite shoulder) and (4) shoulder internal rotation (CHD-IR). Participants were asked to sit with their arms by their sides and to perform the 4 different positions respectively. The measurements were repeated for 3 trials with repositioning of the arm to a neutral position for intervals of 10 seconds. The distance measured was that between the coracoid process and the lesser tuberosity of the humerus. The distance will be measured in the shortest distance between the interval of coracoid process and the lesser tuberosity of the humerus.
- Long Head of Biceps Tendon (LHBT) Stability [ Time Frame: Baseline ]dynamic stability assessment and presence of "chondral print" will be measured for LHBT stability. The probe will be placed at the level of bicipital groove and slightly move upward for short axis image (dynamic stability and "chondral print") and orientated perpendicularly between the bicipital groove for long axis image ("chondral print"). The participant's forearm is placed with the supinated elbow flexed 90° and 10° of IR. Then, the LHBT transposition will be recorded while asking the participant to externally and internally rotation of GH joint for dynamic stability assessment. For "chondral print" evaluation, investigate the presence of irregularity of bicipital groove under short and long axis view.
- Humerus elevation [ Time Frame: Baseline ]The Polhemus 3Space FASTRAK system (Polhemus Inc., Colchester, VT, USA) is an electromagnetic motion analysis system with Motion Monitor software which is used to collect three-dimensional scapular kinematics. The sensors will be attached to bony landmarks (sternum, the scapular acromial process, and the distal humerus between the lateral and medial epicondyles). The recording will be started with the participants in a sitting position, and two hands at the sides. Then, the participants will be asked to perform 5 trials of full ROM scapular plane elevation, and simultaneously we measuring the kinematic data. The humerus elevation, scapular upward/downward rotation, anterior/posterior tipping and internal/external rotation, elevation/depression will be calculated by the software. The kinematic data will be recorded during 30°, 60°, 90° and 120° in raising and lowering phase of humeral elevation in the scapular plane.
- Scapular upward/downward rotation [ Time Frame: Baseline ]See outcome 4
- Scapular anterior/posterior tipping [ Time Frame: Baseline ]See outcome 4
- Scapular internal/external rotation [ Time Frame: Baseline ]See outcome 4
- Scapular elevation/depression [ Time Frame: Baseline ]See outcome 4
- Scapular muscles activities [ Time Frame: Baseline ]Electromyography surface silver chloride circular electrodes with an interelectrode distance of 20 mm, and a Grass AC/DC amplifier with a gain of 1,000, a common mode rejection ratio of 86 dB at 60 Hz, and a bandwidth (-3 dB) of 10 - 1,000 Hz were used. The sEMG data will be collected at 2,000 Hz/channel using a 16-bit analog to digital converter. Each electrode will be controlled with an impedance less than 10 k. The procedures of the recording of the sEMG activity are the same as the kinematic data. A RMS algorithm will be used to produces sEMG envelopes with a sampling rate of 50. Results will be normalized to the maximal activity during MVIC trials. Upper trapezius(UT), long head of biceps(LHB), lower trapezius(LT) and serratus anterior(SA) muscle activation in 0-30°, 30°-60°, 60°-90°, 90°-120° and >120° in raising and lowering phase will be recorded. The mean sEMG amplitude of each phase will be reported as a percentage of MVIC to assess the activity of each muscle.
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Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05371457
|National Taiwan University Hospital|
|Taipei, Taiwan, 100|
|Principal Investigator:||Jiu- Jenq Lin, PHD||School and Graduate Institute of Physical Therapy College of Medicine, National Taiwan University|