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This study investigates the efficacy of combining Transfer Energy Capacitive and Resistive (TECAR) therapy with standard strengthening exercises in treating Shoulder Impingement Syndrome (SIS). A double-blinded randomized controlled trial will compare outcomes between patients receiving only strengthening exercises and those receiving both TECAR therapy and exercises. Key outcomes include improvements in pain, muscle strength, joint position sense, and shoulder function. The study aims to determine if TECAR therapy enhances treatment benefits beyond those achieved with exercises alone.
Background: Shoulder Impingement Syndrome (SIS) is a prevalent musculoskeletal condition characterized by pain and functional impairment due to the compression of rotator cuff tendons beneath the coracoacromial arch. Despite the effectiveness of conservative treatments such as strengthening exercises, there is emerging interest in additional modalities, including Transfer Energy Capacitive and Resistive (TECAR) therapy. TECAR therapy utilizes high-frequency electromagnetic waves to provide deep thermal energy, potentially enhancing tissue repair and pain relief.
Objective: This study aims to evaluate the effectiveness of combining TECAR therapy with a standard strengthening exercise regimen compared to strengthening exercises alone in patients with SIS.
Methods: A double-blinded randomized controlled trial will be conducted with 30 participants diagnosed with Neer's Stage I SIS. Participants will be randomly assigned to either a control group receiving only strengthening exercises or an experimental group receiving both TECAR therapy and strengthening exercises. The study will assess pain, shoulder muscle strength, joint position sense, and shoulder function using a range of validated instruments including the Visual Analogue Scale (VAS), Hand-Held Dynamometer (HHD), Digital Inclinometer, and the Shoulder Pain and Disability Index (SPADI).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| strength training program group | Active Comparator | In Group I, fifteen patients will undergo a 3-week exercise program, with sessions lasting 35-45 minutes, three times a week. Each session includes five exercises, each performed for three sets of 10 repetitions: Shoulder Retraction - Strengthens muscles between shoulder blades. Shoulder Scaption - Improves stability and range of motion. Shoulder External Rotation from Side Lying - Targets rotator cuff muscles. Shoulder Protraction - Enhances shoulder blade function. Shoulder Extension - Strengthens posterior shoulder muscles. |
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| Experimental TECAR Group | Experimental | In the experimental group, fifteen patients will follow a three-week program that combines targeted exercises with Transfer Energy Capacitive and Resistive (TECAR) therapy. Each session of the exercise program, conducted three times a week, will include a series of five shoulder exercises: retraction, scaption, external rotation from a side-lying position, protraction, and extension. Alongside these exercises, patients will receive TECAR therapy, which involves applying high-frequency electromagnetic energy to the affected shoulder. During the therapy, a capacitive electrode will first be used for ten minutes to target the soft tissues near the biceps. Following this, the therapy will switch to the resistive mode for another ten minutes, focusing on the deeper tissues around the T1-T9 vertebrae. Each TECAR session will last for a total of twenty minutes, and patients will undergo this treatment nine times over the course of the study, with three sessions each week. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transfer Energy Capacitive Resistive Therapy | Device | It's a physical treatment modality commonly used to treat musculoskeletal pain. It normally uses a longwave radiofrequency of ~0.5 MHz. The system consists of a neutral plate and two different electrodes that can transfer energy in two modalities: capacitive and resistive |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analog Scale | which rates pain intensity from 0 (no pain) to 10 (worst possible pain) | 3 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Manual Muscle Test System (MMT) | will be used to obtain normative strength values for both external and internal shoulder rotators . | 3 weeks |
| Joint Position Sense of the Shoulder joint | All participants will be submitted to the evaluation of the JPS at 30° and 120° of shoulder forward flexion, using a digital inclinometer |
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Inclusion Criteria:
Both gender age from 25-40 with a clinical diagnosis of Neer's stage II SIS and body mass index (18.5-29.9)
Exclusion Criteria:
Symptoms of cervical radiculopathy.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mostafa Mohamed Abdelkhalek, B.Sc | Contact | 929-435-8403 | drmostafamohamedgalal@gmail.com | |
| ahmed mohamed khalil, PhD | Contact | 929-435-8403 | ahmedazizkhalil90@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Enas Fawzy Youssif, Professor | Cairo University | Study Chair |
| ahmed mohamed khalil, PhD | Pharos University in Alexandria | Study Director |
| Sherif Hamdy Zawam, PhD |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19482984 | Result | Davies H, Wells F, Czarkowski M. Standards for research ethics committees: purpose, problems and the possibilities of other approaches. J Med Ethics. 2009 Jun;35(6):382-3. doi: 10.1136/jme.2008.027722. | |
| 26172661 | Result | Yi SD, Baek SK. Interrupted coarsening in the zero-temperature kinetic Ising chain driven by a periodic external field. Phys Rev E Stat Nonlin Soft Matter Phys. 2015 Jun;91(6):062107. doi: 10.1103/PhysRevE.91.062107. Epub 2015 Jun 5. |
| Label | URL |
|---|---|
| The Effectiveness of an Upper Extremity Neuromuscular Training Program on the Shoulder Function of Military Members With a Rotator Cuff Tendinopathy: A Pilot Randomized Controlled Trial | View source |
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Double-blinded randomized controlled trial
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| strength training program | Other | Each session includes five exercises, each performed for three sets of 10 repetitions: Shoulder Retraction - Strengthens muscles between shoulder blades. Shoulder Scaption - Improves stability and range of motion. Shoulder External Rotation from Side Lying - Targets rotator cuff muscles. Shoulder Protraction - Enhances shoulder blade function. Shoulder Extension - Strengthens posterior shoulder muscles |
|
| 3 weeks |
| shoulder Function Using the Arabic SPADI Questionnaire | The Arabic SPADI is recommended for the evaluation of Arabic-speaking patients with shoulder dysfunction . To answer the questions, patients will be asked to place a mark on a 10 cm visual analogue scale for each question. Verbal anchors for the pain dimension are 'no pain at all' and 'worst pain imaginable', and those for the functional activities are 'no difficulty' and 'so difficult, it required help'. The scores from both dimensions are averaged to derive a total score | 3 weeks |
| Cairo University |
| Study Director |
| 31178148 | Result | Braun BJ, Osche D, Rollmann M, Orth M, Morsdorf P, Histing T, Pohlemann T, Herath SC. Increased therapy demand and impending loss of previous residence status after proximal femur fractures can be determined by continuous gait analysis - A clinical feasibility study. Injury. 2019 Jul;50(7):1329-1332. doi: 10.1016/j.injury.2019.05.007. Epub 2019 May 18. |
| Effectiveness of microwave diathermy on pain, functional capacity, muscle strength, quality of life, and depression in patients with subacromial impingement syndrome: a randomized placebo-controlled clinical study | View source |
| Restricted scapular mobility during arm abduction: implications for impingement syndrome | View source |
| ID | Term |
|---|---|
| D019534 | Shoulder Impingement Syndrome |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D000070599 | Shoulder Injuries |
| D014947 | Wounds and Injuries |
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