Effects of ischemic compression and instrument-assisted soft tissue mobilization techniques in trigger point therapy in patients with rotator cuff pathology: randomized controlled study

Background:Frozen shoulder has a greater incidence, more severe course, and resistance to treatment in patients. Management is based on the underlying cause of pain and stiffness. Joint mobilization has been reported to improve joint range of motion in frozen shoulder. However, there is no information regarding the effect of instrument-assisted soft tissue mobilization (IASTM) in frozen shoulder. We proposed that there would be no significant difference between the two manual physical therapy techniques with relatively similar treatment effects in the frozen shoulder.Objectives:The aim of this randomized controlled study was to compare the effectiveness of IASTM and joint mobilization in the treatment of patients with frozen shoulder.Methods:Thirty patients with phase II frozen shoulder (mean age 50,9 years, age range 39–65 years) were randomly assigned to one of the two treatment groups: Group I received joint mobilization combined with manual stretching exercise and Group II received IASTM with manual stretching exercise (two days per week for six weeks) (Figure 1). The pain level was evaluated with a visual analogue scale (VAS) and the active range of motion (ROM) was measured with a universal goniometer. The Disabilities of the Arm, Shoulder and Hand score and the Constant-Murley score were used for functional assessment. The assessments were performed at baseline and after the 6-week intervention.Figure 1.Instrument-Assisted Soft Tissue MobilizationResults:Both groups had a significant decrease in pain according to VAS and a significant increase in ROM and function level (p<0.05). After the 6-week intervention, improvement of shoulder abduction ROM in Group I was found significantly higher than Group II (p=0.01), on the other hand, Constant-Murley score in Group II was found significantly higher compared to Group I (p=0,001).Conclusion:Our results supported the hypothesis that either joint mobilization or IASTM, performed in addition to stretching exercise, provided similar improvements in pain levels in patients with the frozen shoulder.References:[1]Kelley MJ, Shaffer MA, Kuhn JE, Michener LA, Seitz AL, Uhl TL, et al. Shoulder Pain and Mobility Deficits: Adhesive Capsulitis, J Orthop Sports Phys Ther, 2013:43:1-31.[2]Celik D, Kaya Mutlu E.Does AddingMobilization toStretchingImprove Outcomes for People with Frozen Shoulder? A Randomized Controlled Clinical Trial, Clin Rehab, 2016: 30(8): 786-794.[3]Iked N, Otsuka S, Kawanishi Y, Kawakami Y. Effects of Instrument-Assisted Soft Tissue Mobilization on Musculoskeletal Properties, Med Sci Sports Exerc, 2019:51(10): 2166-2172.Disclosure of Interests:None declared

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The Effects of Rigid Scapular Taping on the Subacromial Space in Athletes With and Without Rotator Cuff Tendinopathy: A Randomized Controlled Study

Journal of Sport Rehabilitation ◽

10.1123/jsr.2017-0287 ◽

2019 ◽

Vol 28 (3) ◽

pp. 250-255 ◽

Cited By ~ 5

Author(s):

Hio Teng Leong ◽

Siu Ngor Fu

Keyword(s):

Rotator Cuff ◽

Confidence Interval ◽

Repeated Measures ◽

Mean Difference ◽

Randomized Controlled Study ◽

Controlled Study ◽

Shoulder Abduction ◽

Subacromial Space ◽

Randomized Controlled ◽

University Laboratory

Context:Reduction of the subacromial space (SAS) during arm elevation may contribute to rotator cuff (RC) tendinopathy. The effects of scapular taping on the SAS in athletes with and without RC tendinopathy are unknown.Objective:To investigate the immediate effects of scapular taping on the SAS in athletes with and without RC tendinopathy.Design:Randomized controlled study with repeated measures.Setting:University laboratory.Participants:A total of 43 male volleyball players (17 asymptomatic and 26 with RC tendinopathy, mean age = 22.9 [3.5] y) participated in the study.Intervention:Three scapular taping protocols—no taping (control), taping with tension (therapeutic taping), and taping without tension (sham taping).Main Outcome Measures:Ultrasound measurements of the SAS with the arm at 0° and 60° of shoulder abduction, and the change in the SAS between 0° and 60° of shoulder abduction (SAS0°–60°) were calculated.Results:Athletes with RC tendinopathy demonstrated larger SAS with therapeutic taping at 60° of shoulder abduction (6.9 [1.9] mm vs 5.8 [1.7] mm, mean difference = 1.1 mm, 95% confidence interval, −1.80 to −0.39,P = .002) when compared with the no taping condition. The tendinopathy group also showed less reduction in the SAS with therapeutic taping during SAS0°–60°(2.0 [1.4] mm vs 2.8 [1.4] mm,P = .02) when compared with the no taping condition. When tape was applied to the scapula in asymptomatic athletes, our results showed a relatively small increase in the SAS with therapeutic taping during arm resting at 0° of abduction when compared with the no taping condition (8.7 [0.9] mm vs 8.3 [0.8] mm, mean difference = 0.4 mm, 95% confidence interval, −0.71 to −0.11,P = .01).Conclusions:Athletes with RC tendinopathy demonstrated less reduction of the SAS with rigid scapular taping during early arm abduction. Such observation was not evidenced in asymptomatic athletes.

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