Functional massage of the teres major muscle in patients with subacromial impingement syndrome: a randomized controlled case series study

Abstract

Objective: the purpose of the present study was to analyze the concurrent validity and reliability of a force platform clinical COBS Feedback® for the estimation of the height of vertical jumps. Design: a cross-sectional correlational and comparative study. Setting: University Human Movement and Physiotherapy Laboratory. Participants: healthy university students (14 female and 13 male) aged between 18 and 25 years old (mean = 20.074 ±1.542). Main Outcome Measures: vertical jump heights, technical error and grade of agreement between methods of measurement. Results: after the 27 subjects performed a total of 135 vertical jumps on COBS Feedback®platform while simultaneously being recorded with a high-speed camera-based method, the intraclass correlation coefficient showed an almost perfect concordance between the two methods (ICC = 0.916, CI95%= 0.882 to 0.940, p<0.001). The technical error of the COBS Feedback® against HSC-Kinovea video analysis was at 0.310±0.223m, being higher in males than in females (t= -2.822, CI95%: -0.376 to -0.574, p=0.001). Conclusions: the COBS Feedback® method provided a valid measurement of the flight times for estimate the vertical jump height as a number of well-known tests and devices.Aims: Subacromial impingement syndrome is the most common shoulder condition. Myofascial trigger points in teres major muscle can be associated with this syndrome. Our objective is to determine whether adding manual therapy specifically for teres major trigger points can produce better results in these patients. Study Design: Randomized controlled case series. Place and Duration of Study: Public Primary Care Center in the Spanish National Health System (Cornellà de Llobregat - Barcelona) and the FREMAP Mutual Society for Work-related Injuries and Occupational Illness (Arnedo - La Rioja), between January and March 2014. Methodology: Fifty-eight people were recruited but 8 subjects were lost during the follow-up period. The sample consisted of 50 patients (17 male and 33 female, age range 23-80 years) randomly assigned to one of two groups: the intervention group or the control group. Both groups received a protocolized physical therapy treatment, while the intervention group also received manual therapy for teres major trigger points. Results: Pain intensity (p=.01) and function (p=.01) showed significant improvement in the control group, whereas pain intensity (p=.01), function (p=.01) and active range of motion (p=.01) showed significant improvement in the intervention group. Between-group differences were statistically significant for abduction (p=.01), extension (p=.02) and lateral rotation (p=.02), and clinically significant (Cohen’s d) for function, flexion, extension, lateral rotation and abduction. Conclusion: Although our findings must be considered as preliminary, they suggest that adding manual therapy to treat teres major trigger points achieves better results in the glenohumeral range of motion.