Latissimus Dorsi Strengthening Exercises in Rotator Cuff Tendinopathy

Condition(s) studied

Investigational drug(s) / intervention(s)

Rotator Cuff Strengthening Exercises: Progressive exercise program focused on rotator cuff muscles

Latissimus Dorsi Strengthening Exercises: Progressive exercise program targeting the latissimus dorsi muscle

Study summary

The aim of this study is to investigate the effects of strengthening exercises targeting the latissimus dorsi muscle on acromiohumeral distance, shoulder function, and pain levels in individuals with rotator cuff tendinopathy. By increasing the activation of the latissimus dorsi, one of the shoulder adductor muscles, the exercises are expected to facilitate inferior gliding of the humeral head and improve subacromial distance.

Individuals aged between 18 and 50 years with a diagnosis of rotator cuff tendinopathy will be included in the study. A total of 47 participants will be enrolled and randomly assigned to one of three groups:

A group performing exercises targeting only the rotator cuff muscles, A group performing exercises targeting the latissimus dorsi muscle, A group performing a combination of both rotator cuff and latissimus dorsi exercises.

The exercise interventions will be applied over a 12-week period. Before and after the intervention, the following outcomes will be assessed:

Acromiohumeral distance (via ultrasound), Range of motion, Shoulder function and pain using the SPADI and WORC questionnaires, and Avoidance behavior using the Adap-Tr questionnaire.

Eligibility

Primary outcome measure(s)

• Acromio-humeral distance — Measurements will be performed at baseline and at the end of the 12th week
  The acromiohumeral distance will be assessed using ultrasonography. Measurements will be performed by a physician blinded to the participants' group assignments, ensuring assessor blinding. Ultrasonographic measurement of the acromiohumeral distance has been shown to be reliable (intraclass correlation coefficient \> 0.90), and the minimal detectable change has been reported as 1.2 mm
• Pain İntensity — Baseline and weekly up to 12 weeks
  Pain intensity will be assessed using the Visual Analog Scale (VAS) at rest, during activity, and at night. On the VAS, a score of 0 indicates no pain, while a score of 10 represents unbearable pain. Higher scores reflect greater pain intensity.he scale will be explained to the patient in a face-to-face setting, and they will be asked to mark their pain levels at rest, during activity, and at night on a 100-millimeter horizontal line.
• Shoulder Range of Motion — Baseline and weekly up to 12 weeks
  ll measurements will be performed with the patient in the supine position. For shoulder flexion ROM, the patient will be asked to raise their arm upward in the sagittal plane. For shoulder abduction ROM, the patient will be instructed to move their arm laterally in the scapular plane.For external and internal rotation ROM measurements, the shoulder will be positioned at 90° of abduction and the elbow at 90° of flexion.For external rotation, the patient will be asked to move the forearm upward in the sagittal plane, with the palm facing toward themselves and in the direction of the thumb. For internal rotation, the patient will be asked to move the forearm downward in the sagittal plane, in the direction of the index finger.

Trial sites (1)

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