Transcranial Electrical Stimulation in Subacromial Pain Syndrome
Effectiveness of Transcranial Electrical Stimulation in the Functional Recovery of Subjects with Subacromial Pain Syndrome: Randomized Clinical Trial.
University of Valencia
74 participants
Nov 23, 2023
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to analyze whether a physiotherapy protocol based on strengthening exercises to the shoulder girdle muscles carried on during anodal transcranial electrical stimulation (a-TES) is more effective on the symptoms and functionality of subjects with subacromial pain syndrome than an isolated strengthening program. The main questions it aims to answer are: * Is the strengthening + a-TES protocol effective on functionality? * Is the strengthening + a-TES protocol effective on quality of life? * Is the strengthening + a-TES protocol effective on pain? * Is the strengthening + a-TES protocol effective on muscle strength? * Is the strengthening + a-TES protocol effective on active range of movement? * Is the strengthening + a-TES protocol effective on proprioception? * Is the strengthening + a-TES protocol effective on posture? * Is the strengthening + a-TES protocol effective on glenohumeral and scapulothoracic kinematics? Participants will perform an 8 weeks-3 days/week shoulder strengthening protocol for the rotator cuff and scapulothoracic muscles using elastic bands and dumbbells. The rotator cuff exercises will be performed while they receive a-TES using a neoprene helmet with the electrodes placed in the opposite hemisphere to the affected side. The scapulothoracic exercises will be performed without the transcranial stimulation. The experimental group will receive real a-TES, and will be compared with a control group that will perform the same therapeutic exercises but with placebo a-TES to see the effectiveness of the a-TES on the outcomes cited above.
Eligibility
Inclusion Criteria9
- Subjects will be evaluated during a first consultation by a physiotherapist with experience in shoulder musculoskeletal pathology, following the algorithm for the diagnosis of shoulder problems, recommended by the British Elbow \& Shoulder Society with the aim of detecting possible "flags red" and as a guide to rule out other shoulder pathologies that do not fit into the SDS. However, other tests will be added to ensure diagnostic accuracy, and these are described below.
- Age between 18 and 65 years.
- Duration of pain greater than or equal to 3 months.
- Presence of 3 or more of the following positive clinical tests:
- painful arc
- External rotation test against isometric resistance
- Neer's test
- Jobe test or empty can test
- Hawkins-Kennedy test
Exclusion Criteria22
- Previous shoulder or neck surgery.
- History of shoulder fracture or dislocation.
- Medical diagnosis of shoulder osteoarthritis.
- Adhesive capsulitis
- Cervicobrachialgia or reproducible shoulder pain with neck movements.
- Clinical signs of total tear of the rotator cuff.
- Corticosteroid injection in the previous 6 weeks.
- Inflammatory disease, autoimmune or rheumatic, systemic (arthritis, lupus, myopathies).
- Cognitive or behavioral problems that make it impossible to understand and follow the intervention (score less than 24 on the Mini-Mental State Examination Score) (73).
- Any neurological or neoplastic disease.
- Also those who present contraindications for transcranial electrical stimulation. For this, the recommendations of the checklist of Thair et al. which includes:
- personal and family history of epilepsy
- metal implants in the head
- implanted medication pump
- pacemaker
- recurring headaches
- skin diseases of the scalp (psoriasis, eczema)
- head injuries
- serious head surgeries
- pregnancy
- heart diseases
- medications (psychotropics or antihistamines).
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Interventions
Strenghtening of rotator cuff and scapulothoracic muscles protocol with the incorporation of anodal transcranial direct stimulation (real if experimental or sham if control)
Locations(1)
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NCT05951933