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Effects of Mulligan's Technique in Subjects With Shoulder Impingement Syndrome

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ClinicalTrials.gov Identifier: NCT02463526
Recruitment Status : Completed
First Posted : June 4, 2015
Last Update Posted : December 22, 2015
Sponsor:
Collaborator:
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Information provided by (Responsible Party):
João Flávio Guimarães, Universidade Federal de Sao Carlos

Brief Summary:
Participants will be initially assessed for their suitability for inclusion in the study and will undergo a physical screening of the affected shoulder and cervical spine by an experienced physiotherapist. After, participants will be attended 72 hours after data recording of the baseline measures (range of motion with a goniometer, pressure pain threshold with a algometer, and peak force with a dynamometer) for four sessions per week with 24 hours of interval between sessions. At each experimental week session, each participant will receive one of the two treatment conditions (MWM or sham) and then will repeats the assessment. In the following week, there will be a crossover condition of each individual and 24 hours after the last treatment session, the examiner will do the last assessment.

Condition or disease Intervention/treatment Phase
Shoulder Impingement Syndrome Other: Mobilization with Movement (MWM) condition/ Sham condition Other: Sham condition/ Mobilization with Movement (MWM) condition Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 27 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single (Investigator)
Primary Purpose: Treatment
Official Title: The Effects of Mulligan's Technique on Range of Movement, Pressure Pain Threshold, Muscle Strength, and Functionality in Subjects With Shoulder Impingement Syndrome
Study Start Date : April 2015
Actual Primary Completion Date : December 2015
Actual Study Completion Date : December 2015

Arm Intervention/treatment
Experimental: Group 1 - MWM condition/Sham condition
Subjects will receive treatment for 4 times with Mulligan's Mobilization with Movement (MWM) condition, and after 72 hrs, will be treated 4 times with the sham condition.
Other: Mobilization with Movement (MWM) condition/ Sham condition
The treatment condition consists in the application of a posterolateral glide (MWM) in the affected shoulder. Subjects will be seated and the therapist will stay beside the participants on the opposite side to the affected shoulder. One hand will be placed over the scapula posteriorly while the thenar eminence of the other hand will be placed over the humerus head anterior aspect. A posterior glide will be applied to the humeral head. Three sets of 10 repetitions will be applied with a 30 seconds rest interval between each set. Sham condition will replicate treatment condition except for the hand positioning. The therapist will place one hand along the clavicle and the other on the humeral head posterior aspect of the affected shoulder. A simulated anterior glide will be performed.

Other: Sham condition/ Mobilization with Movement (MWM) condition
The Sham condition consists in the application of a simulated anterior glide in the affected shoulder. Subjects will be seated and the therapist will stay beside the participants on the opposite side to the affected shoulder. The therapist will place one hand along the clavicle and the other on the humeral head posterior aspect of the affected shoulder. A simulated anterior glide will be performed. Three sets of 10 repetitions will be applied with a 30 seconds rest interval between each set. The treatment condition will replicate treatment condition except for the hand positioning. The therapist will place one hand over the scapula posteriorly while the thenar eminence of the other hand will be placed over the anterior humerus head. A posterior glide will be applied to the humeral head.

Experimental: Group 2 - Sham condition/MWM condition
Subjects will receive treatment for 4 times with sham condition, and after 72 hrs, will be treated 4 times with the Mulligan's Mobilization with Movement (MWM) condition.
Other: Mobilization with Movement (MWM) condition/ Sham condition
The treatment condition consists in the application of a posterolateral glide (MWM) in the affected shoulder. Subjects will be seated and the therapist will stay beside the participants on the opposite side to the affected shoulder. One hand will be placed over the scapula posteriorly while the thenar eminence of the other hand will be placed over the humerus head anterior aspect. A posterior glide will be applied to the humeral head. Three sets of 10 repetitions will be applied with a 30 seconds rest interval between each set. Sham condition will replicate treatment condition except for the hand positioning. The therapist will place one hand along the clavicle and the other on the humeral head posterior aspect of the affected shoulder. A simulated anterior glide will be performed.

Other: Sham condition/ Mobilization with Movement (MWM) condition
The Sham condition consists in the application of a simulated anterior glide in the affected shoulder. Subjects will be seated and the therapist will stay beside the participants on the opposite side to the affected shoulder. The therapist will place one hand along the clavicle and the other on the humeral head posterior aspect of the affected shoulder. A simulated anterior glide will be performed. Three sets of 10 repetitions will be applied with a 30 seconds rest interval between each set. The treatment condition will replicate treatment condition except for the hand positioning. The therapist will place one hand over the scapula posteriorly while the thenar eminence of the other hand will be placed over the anterior humerus head. A posterior glide will be applied to the humeral head.




Primary Outcome Measures :
  1. Pressure Pain Threshold [ Time Frame: 72 hours before the treatment starts, 24 hours after the last MWM or Shaw treatment, and 24 hours after the last treatment. ]
    The pressure pain threshold will be assessed with a algometer and the unit of measure is the kilogram per square centimeter.


Secondary Outcome Measures :
  1. Range of Motion [ Time Frame: 72 hours before the treatment starts, 24 hours after the last MWM or Shaw treatment, and 24 hours after the last treatment. ]
    The range of motion will be assessed with a goniometer and the unit of measure is the degree

  2. Peak Force [ Time Frame: 72 hours before the treatment starts, 24 hours after the last MWM or Shaw treatment, and 24 hours after the last treatment. ]
    The Peak Force will be assessed with a handheld dynamometer and the unit of measure is the kilogram.



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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • history of shoulder pain of >1-week duration, localized at the proximal anterolateral shoulder region consistent to Shoulder Impingement Syndrome (SIS);
  • at least 1 positive impingement test (Jobe's test, Neer's test, Hawkins-Kennedy's Test) associated with painful range of motion during arm elevation; or pain during external rotation with the arm in 90 degrees of elevation in the coronal plane.

Exclusion Criteria:

  • fibromyalgia (based on self-report),pregnancy, a history of onset of symptoms because of traumatic injury, other histories of shoulder injury, torn tendons, ligamentous laxity based on positive Sulcus test and apprehension test, numbness or tingling in the upper extremity, previous shoulder or neck surgery, systemic illnesses, body mass index > 28kg/m2, corticosteroid injection 3 months before evaluation, physical therapy 3 months before evaluation.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02463526


Locations
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Brazil
UFSCar
São Carlos, São Paulo, Brazil, CEP 13565-905
Sponsors and Collaborators
Universidade Federal de Sao Carlos
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Investigators
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Study Director: Francisco Alburquerque-Sendín, Professor Universidade Federal de Sao Carlos
Study Chair: Tania Salvini, Professor Universidade Federal de Sao Carlos

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Responsible Party: João Flávio Guimarães, Master students, Universidade Federal de Sao Carlos
ClinicalTrials.gov Identifier: NCT02463526     History of Changes
Other Study ID Numbers: U1111-1154-7379
28898014.3.0000.5504 ( Other Identifier: Plataforma Brasil )
First Posted: June 4, 2015    Key Record Dates
Last Update Posted: December 22, 2015
Last Verified: December 2015
Keywords provided by João Flávio Guimarães, Universidade Federal de Sao Carlos:
Shoulder Impingement Syndrome
Mulligan's Mobilization with Movement
Physical Therapy
Additional relevant MeSH terms:
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Shoulder Impingement Syndrome
Syndrome
Rotator Cuff Injuries
Disease
Pathologic Processes
Rupture
Wounds and Injuries
Shoulder Injuries
Tendon Injuries
Joint Diseases
Musculoskeletal Diseases