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To investigate the effect of PMI release on subacromial space, pectoralis minor length, shoulders ROM, shoulder joint pain, and functional ability in patients with SAIS.
Statement of the problem:
This study will be designed to answer the following question Does PMI release have an effect on subacromial space in patients with SAIS?
The purposes of the study:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| traditional group | Sham Comparator | Thirty patients will receive traditional physical therapy treatment (Postural correction exercises and scapular stabilization exercises) at the painful shoulder, Treatment sessions will be two times per week for six weeks |
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| Experimental Group | Experimental | Thirty patients will receive traditional treatment plus pectoralis minor stretching and release, Treatment sessions will be two times per week for six weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| conventional physical therapy | Other | Physiotherapy treatment included passive manual joint mobilization, home-based strengthening exercises and advice on posture, twice a week. So, we will apply this conventional physical therapy to control group
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| Measure | Description | Time Frame |
|---|---|---|
| Subacromial space will be measured by X-ray image | The radiograph will be done to measure acromio-humeral distance, which is considered the shortest distance between the inferior cortex of acromion and the top of humeral head. In normal shoulders, the sub acromial space was between 9 and 10 mm. The space was significantly greater in men, with a slight reduction with age. In middle age, a sub-acromial space less than 6 mm is pathological | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Pectoralis minor length will be measured by tape measurement | Participants will be asked to remain in a relaxed posture with the arms at the side in a neutral position, avoid postural correction, and exhale just before the measurement. A tape measure was used to measure the linear distance between the origin and insertion of the muscle. The primary investigator of the study performed all measurements. The origin was defined as the inferior aspect of the 4th rib, which was one finger width lateral to the sternum, just lateral to the sternocostal junction. The insertion was defined as the medial-inferior aspect of the coracoid process . |
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Inclusion Criteria:
Exclusion Criteria:
All patients who have any of the following will be excluded from the study (Lewis and Valentine 2007)
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Physical Therapy Cairo University | Giza | Dokki | 12612 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Abu EL Kasem Sh., Alaa F., Abd EL-Raoof N. et al., (2024):" Efficacy of Mulligan thoracic sustained natural apophyseal glides on sub-acromial pain in patients with sub-acromial impingement syndrome: a single-blinded randomized controlled trial "journal of manual & manipulative therapy 10.1080/10669817.2024.2341453 Amado A., Marques A., Maiorino R. et al., (2006):" An Anatomical Study of The Subcoracoid Space" CLINICS 2006;61(5):467-72 Ann Sisto S. and Dyson-Hudson T. (2007):" Dynamometry testing in spinal cord injury" Journal of Rehabilitation Research & Development, Volume 44, Number 1 Anne T., Herrington L., Horlsey I. et al. (2015):" An evidence-based review of current perceptions with regard to the subacromial space in shoulder impingement syndromes: Is it important and what influences it?" Clinical Biomechanics , Volume 30, Issue 7, August 2015, Pages 641-648 |
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| 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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| Experimental group therapy | Other | Treatment will be conventional treatment with pectoralis minor release and stretch.
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| 6 month |
| Shoulder joint ROM (flexion, abduction, internal and external rotation) will be measured by inclinometer | Shoulder flexion, abduction, internal and external rotation movements will be measured with the individual seated upright on a non-reclining high-back chair, to limit trunk compensation. The chair was the same for all movements performed by one individual, but different for each individual, to provide support up to the middle of the scapula. Shoulder movements will be actively and passively evaluated for flexion in supine and seated positions, abduction, external rotation in a neutral position with 0° abduction (ERN), external rotation with the arm at 90° of abduction (ER90), and internal rotation with the arm at 90° of abduction (IR90) using an Acumar digital inclinometer . | 6 month |
| Pain intensity will be measured by using VAS ( visual analog scale) | The patients' pain severity will be evaluated using a visual analog scale (VAS). The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between 0 "no pain" and 10 "worst pain | 6 month |
| Identification of Functional Ability of the shoulder joint using Q-DASH questionnaire with Arabic version | The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper extremity disability and symptoms The use of the DASH questionnaire as an outcomes instrument in patients with upper-extremity complaints. The main part of the Quick-DASH is a 14-item disability/symptom scale concerning the patient's health status during the preceding week. The items ask about the degree of difficulty in performing different physical activities as well as the problem's impact on social activities, work, sleep, and self-image. Each item has five response options. The scores for all items are then used to calculate a scale score ranging from 1 (no difficulty) to 5 ( unable). | 6 month |