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Brief Summary:
The purpose of this study is to evaluate the effects of Blackburn exercises on Scapulothoracic stability in patients with Type-1 Scapular Dyskinesia, in comparison with conventional physical therapy. A randomized control trial is being conducted at National Institute of Rehabilitation Medicine (NIRM), Islamabad and Railway Hospital, Rawalpindi. The sample size was calculated through open epi tool, is 38. The participants are divided into two equal groups, 19 participants in experimental group and 19 participants in control group. The study duration is six months. Sampling technique applied is non-probability convenient sampling and groups have been randomized using sealed envelope method. Participants aged 25-55 years, having Type-1 Scapular Dyskinesia due to shoulder related causes, positive scapular assistance test, bilateral distance>1.5 cm in Lateral scapular slide test are being included in the study. Tools that are being used in this study are Lateral Scapular Slide Test, handheld dynamometer, Static measurements with scapula goniometry, and Shoulder pain and disability index (SPADI). Data will be analyzed through Statistical Package for Social Sciences (SPSS).
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Scapular Dyskinesis | Other: Blackburn exercises Other: Conventional Physical therapy | Not Applicable |
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| Study Type : | Interventional (Clinical Trial) |
| ActualEnrollment : | 38 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | Single (Outcomes Assessor) |
| Primary Purpose: | Treatment |
| Official Title: | Effects of Blackburn Exercises on Scapulothoracic Stability in Patients With Type-1 Scapular Dyskinesia |
| Actual Study Start Date : | February 1, 2021 |
| Actual Primary Completion Date : | August 1, 2021 |
| Actual Study Completion Date : | August 1, 2021 |
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| Arm | Intervention/treatment |
|---|---|
| Experimental: Blackburn exercises Blackburn exercises and hot pack | Other: Blackburn exercises Experimental group will include Blackburn exercises and hot pack for 10 minutes prior to the application of exercises; 3 sessions/week for a total of 4 weeks. Measurement will be taken at base level and after the last session, i.e. bilateral difference in lateral scapular slide test, serratus anterior and lower trapezius muscle strength, static measurements of scapula ROM, and pain and disability. These exercises will include prone horizontal abduction neutral and with full external rotation, prone horizontal scaption neutral and with full external rotation, prone horizontal external rotation, prone horizontal extension. All these exercises will be performed 3x15 repetitions with 30 seconds rest interval between each set. |
| Active Comparator: Conventional physical therapy Conventional physical therapy and hot pack | Other: Conventional Physical therapy Control group will include conventional physical therapy and hot pack for 10 minutes prior to the application of exercises; 3 sessions/week for a total of 4 weeks. Measurement will be taken at base level and after the last session, i.e. bilateral difference in lateral scapular slide test, serratus anterior and lower trapezius muscle strength, static measurements of scapula ROM, and pain and disability. These exercises will include push-ups on a stable surface, upward rotation shrugs and resisted scapular retraction. All these exercises will be performed 3x15 repetitions with 30 seconds rest interval between each set. |
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Primary Outcome Measures :
- Lateral Scapular Slide Test [TimeFrame:12th day]
Changes from baseline bilateral scapular distance are taken with the help of tape measure.
- Handheld Dynamometer [TimeFrame:12th day]
Changes from baseline grip strength are taken with the help of hand dynamometer.
- Static Measurements with Scapular Goniometry [TimeFrame:12th day]
Changes from baseline measurements of infera, lateral displacement and abduction are taken with the help of tape measure and goniometer.
Secondary Outcome Measures :
- Shoulder Pain and Disability Index (SPADI) [TimeFrame:12th day]
It was developed to measure current shoulder pain and disability in an outpatient setting. It consists of a 5-item subscale that measures pain and an 8-item subscale that measures disability. Pain scale is summed up to a total of 40 and disability scale to 80. A total score of 0 indicates best and 100 indicates worst.
Other Outcome Measures:
- Manual Muscle Testing [TimeFrame:12th day]
Changes from the baseline serratus anterior and lower trapezius are taken according to manual muscle testing grading system. Grading Scale Range: 0 to 5 0: None: No visible or palpable contraction,
- Trace: Visible or palpable contraction with no motion
- Poor: Full ROM gravity eliminated
- Fair: Full ROM against gravity
- Good: Full ROM against gravity, moderate resistance
- Normal: Full ROM against gravity, maximul resistance
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Information from the National Library of Medicine 
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
| Ages Eligible for Study: | 25 Years to 55 Years (Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- Type-1 Scapular Dyskinesia patients with shoulder related causes
- Positive scapular assistance test
- Bilateral difference > 1.5 cm in Lateral Scapular Slide Test
Exclusion Criteria:
- Non-shoulder related scapular dyskinesia
- Recent fracture or trauma
- Malignancy
- Severe systemic illness
- Corticosteroid injections in the affected shoulder in the preceding 6-9 weeks
- Any other medically diagnoses orthopaedic, neurological or cardiovascular disorder affecting upper extremity function
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Information from the National Library of Medicine
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04747509
Locations
| Pakistan | |
| National Institute of Rehabilitation Medicine (NIRM) | |
| Islamabad, Federal, Pakistan, 44000 | |
| Railway General Hospital | |
| Rawalpindi, Punjab, Pakistan, 46000 | |
Sponsors and Collaborators
Riphah International University
Investigators
| Principal Investigator: | Saira Waqqar, PHD* | Riphah International University |
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Publications:
Panagiotopoulos AC, Crowther IM. Scapular Dyskinesia, the forgotten culprit of shoulder pain and how to rehabilitate. SICOT J. 2019;5:29. doi: 10.1051/sicotj/2019029. Epub 2019 Aug 20.
Kaur N. Effect of Blackburn Exercises in Scapular Dyskinesia: a case report. Journal of the Gujarat Research Society. 2019 Dec 24;21(8):961-7.
Borloz S, Graf V, Gard S, Ziltener JL. [Scapular dyskinesis]. Rev Med Suisse. 2012 Dec 19;8(367):2422-8. French.
Shankar P, Jayaprakasan P, Devi R. Effect of scapular stabilisation exercises for type 2 scapular dyskinesis in subjects with shoulder impingement. International Journal of Physiotherapy. 2016 Feb 1;3(1):106-10.
Longo UG, Risi Ambrogioni L, Berton A, Candela V, Massaroni C, Carnevale A, Stelitano G, Schena E, Nazarian A, DeAngelis J, Denaro V. Erratum: Longo, U.G., et al. Scapular Dyskinesis: From Basic Science to Ultimate Treatment. International Journal of Environmental Research and Public Health 2020, 17(8), 2974. Int J Environ Res Public Health. 2020 May 27;17(11):3810. doi: 10.3390/ijerph17113810.
Sanchez HM, Sanchez EG. Scapular dyskinesis: biomechanics, evaluation and treatment. Int Phys Med Rehab J. 2018;3(6):514-20.
Jayesh PN, Muragod AR, Motimath B. Open kinematic chain exercises for SICK scapula in competitive asymptomatic over head athletes for 3 weeks. Int J Physiother Res. 2014;2(4):608-15.
Postacchini R, Carbone S. Scapular dyskinesis: diagnosis and treatment. OA Musculoskeletal Medicine. 2013 Oct 18;1(2):20.
Manske RC, Grant-Nierman M, Lucas B. Shoulder posterior internal impingement in the overhead athlete. Int J Sports Phys Ther. 2013 Apr;8(2):194-204.
Panse R, Yeole U, Pawar K, Pawar P. Effects of Blackburn exercises in shoulder impingement on pain and disability in rock climbers. Age. 2018;22:3-57.
Laudner KG, Stanek JM, Meister K. The relationship of periscapular strength on scapular upward rotation in professional baseball pitchers. J Sport Rehabil. 2008 May;17(2):95-105. doi: 10.1123/jsr.17.2.95.
| Responsible Party: | Riphah International University |
| ClinicalTrials.gov Identifier: | NCT04747509 |
| Other Study ID Numbers: | REC/00866 Rimsha Malik |
| First Posted: | February 10, 2021 Key Record Dates |
| Last Update Posted: | April 15, 2022 |
| Last Verified: | April 2022 |
| Individual Participant Data (IPD) Sharing Statement: | |
| Plan to Share IPD: | No |
| Studies a U.S. FDA-regulated Drug Product: | No |
| Studies a U.S. FDA-regulated Device Product: | No |
Keywords provided by Riphah International University:
| Scapulothoracic stability Blackburn exercises Lateral scapular slide test Type-1 Scapular Dyskinesia |
Additional relevant MeSH terms:
| Dyskinesias Movement Disorders Central Nervous System Diseases Nervous System Diseases Neurologic Manifestations |
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