Exercise-induced Hypoalgesia Effects of Blood Flow Restriction in People With Rotator Cuff-related Shoulder Pain

Differences in Exercise-induced Hypoalgesia After a Session With Different Blood Flow Restriction Protocols in People With Rotator Cuff-related Shoulder Pain

This study aims to compare the effects of blood flow restricted (BFR) exercise and to examine the differences between various BFR protocols on acute pain reduction in individuals with rotator cuff-related shoulder pain, as well as the exercise tolerance at each intensity and occlusion setting. There are four exercise modalities corresponding to different combinations of intensity (%RM) and percentage of occlusion (%AOP): 1) 30% RM and 30% AOP; 2) 30% RM and 50% AOP; 3) 30% RM and 70% AOP; 4) 30% RM and BFR placebo (cuff without pressure).

All participants will complete one session of each of the four exercise modalities, analyzing the variables studied in each for subsequent analysis and comparison.

Inclusion Criteria:

• Age between 18 and 65
• Shoulder symptoms lasting at least 3 months
• Pain in the proximal anterolateral aspect of the shoulder, aggravated by abduction
• At least two of the following tests positive: Jobe test, resisted external rotation test, Hawkins-Kennedy test, Neer test, painful arc between 60 and 120 degrees of shoulder abduction

Exclusion Criteria:

• History of shoulder trauma or surgery
• Pain of such intensity that it is impossible to perform the proposed exercises
• Active arm elevation less than 90 degrees
• Clinical signs of a complete tear (positive delayed external and internal rotation sign and positive arm drop test)
• Suspected frozen shoulder (50% reduction or more than 30° loss in passive shoulder external rotation)
• Primary diagnosis of shoulder instability or acromioclavicular pathology
• Shoulder pain due to primary involvement in the cervical or thoracic region
• Corticosteroid injections in the last 6 weeks
• Presence of diseases such as inflammatory arthritis, neurological diseases, fibromyalgia, malignant tumors, or polymyalgia rheumatica
• Presence of more than one risk factor for thromboembolism
• Participation in upper limb exercise programs in the last month