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Interventions focused on the scapula have been frequently used to treat shoulder pain. However, most studies do not assess the contribution of scapular movement alteration for the symptoms.
Objectives: To compare the effects of two interventions for shoulder pain: Scapular Movement Training and General Exercises.
This is a double-blinded randomized controlled trial. Sixty-four subjects with shoulder pain, scapular dyskinesis, and positive scapular assistance test will be randomized in two groups: 1) Scapular Movement Training, and 2) General Exercises. The Scapular Movement Training Group will receive the orientation about proper scapular position and movement, and will be trained to modify the scapular movement pattern. The General Exercises Group will perform scapulothoracic stretching and strengthening exercises.
Both groups will be treated twice a week for eight weeks. The following outcomes will be collected at baseline and follow-up: scapular kinematics, electromyographic muscle activity of the upper, middle and lower trapezius, and serratus anterior, as well as pain intensity, function, and fear avoidance beliefs. Also, pain intensity, function, and fear-avoidance beliefs will be assessed at the fourth week of follow-up after the end of treatment's period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Scapular Movement Training | Experimental | Orientation and scapular exercises, performed twice a week, for 8 weeks. |
|
| General Exercises | Active Comparator | Scapulothoracic muscle stretching and strengthening exercises, performed twice a week, for 8 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Scapular Movement Training | Other | Orientation about the proper scapular position and movement and training to modify the scapular movement pattern. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Three-Dimensional Scapular Kinematics from baseline to 8 weeks. | 3-D Scapular kinematics (upward/downward rotation; internal/external rotation; anterior/posterior tilt) will be measured by an electromagnetic tracking system (in degrees). | Pre (baseline) and post Treatment (8 weeks) |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Muscle activity from baseline to 8 weeks. | Surface electromyographic recorded from scapulothoracic muscles (Upper trapezius, Middle Trapezius, Lower Trapezius and Serratus Anterior). | Pre (baseline) and post Treatment (8 weeks) |
| Change in Pain from baseline to follow-up. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Paula Camargo, PhD | Universidade Federal de Sao Carlos | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universidade Federal de São Carlos | São Carlos | São Paulo | 13565-905 | Brazil |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36000960 | Derived | Kamonseki DH, Haik MN, Ribeiro LP, Almeida RF, Camargo PR. Scapular movement training is not superior to standardized exercises in the treatment of individuals with chronic shoulder pain and scapular dyskinesis: randomized controlled trial. Disabil Rehabil. 2023 Sep;45(18):2925-2935. doi: 10.1080/09638288.2022.2114552. Epub 2022 Aug 24. | |
| 32855073 |
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| ID | Term |
|---|---|
| D020069 | Shoulder Pain |
| D009140 | Musculoskeletal Diseases |
| D007592 | Joint Diseases |
| D000070599 | Shoulder Injuries |
| ID | Term |
|---|---|
| D018771 | Arthralgia |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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|
| General Exercises | Other | Strengthening and stretching exercises. |
|
|
The pain will be measured with 11 point - Numerical Rating Pain Scale with scores ranging from 0 (no pain) to 10 (maximum pain). |
| Pre (baseline), 4 weeks, post Treatment (8 weeks), and follow-up (4 weeks after treatment ) |
| Change in Function from baseline to follow-up. | The Function will be measured with Disabilities of the Arm, Shoulder and Hand with scores ranging from 0 to 100 (higher score reflects greater disability). | Pre (baseline), 4 weeks, post Treatment (8 weeks), and follow-up (4 weeks after treatment ) |
| Change in Fear-Avoidance Beliefs from baseline to follow-up. | The Fear-Avoidance Beliefs Questionnaire (FABQ) contains 2 scales: FABQ work scale (with range from 0 to 42) and FABQ physical activity scale (with range from 0 to 24). Higher scores indicate higher levels of fear-avoidance beliefs. | Pre (baseline), 4 weeks, post Treatment (8 weeks), and follow-up (4 weeks after treatment ) |
| Change in Overall improvement of Symptoms from baseline to follow-up. | The Overall improvement of Symptoms will be measured with the Global Rating of Change Scale with scores ranging from -7 to +7 (A higher score indicates higher recovery from the condition). | Pre (baseline), 4 weeks, post Treatment (8 weeks), and follow-up (4 weeks after treatment ) |
| Change in Kinesiophobia from baseline to follow-up | The Kinesiophobia will be measured with Tampa Scale of Kinesiophobia (TKS) with scores ranging from 17 to 68. Higher scores indicate higher degree of kinesiophobia. | Pre (baseline), 4 weeks, post Treatment (8 weeks), and follow-up (4 weeks after treatment ) |
| Kamonseki DH, Haik MN, Camargo PR. Scapular movement training versus standardized exercises for individuals with chronic shoulder pain: protocol for a randomized controlled trial. Braz J Phys Ther. 2021 Mar-Apr;25(2):221-229. doi: 10.1016/j.bjpt.2020.08.001. Epub 2020 Aug 18. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D014947 | Wounds and Injuries |