Comprehensive supervised heavy training program versus home training regimen in patients with subacromial impingement syndrome: a randomized trial

Background There is no consensus on the best training regimen for subacromial impingement syndrome (SIS). Several have been suggested, but never tested. The purpose of the study is to compare a comprehensive supervised training regimen (STR) based on latest evidence including heavy slow resistance training with a validated home-based regimen (HTR). We hypothesized that the STR would be superior to the HTR. Methods Randomised control trial with blinded assessor. 126 consecutive patients with SIS were recruited and equally randomised to 12 weeks of either supervised training regimen (STR), or home-based training regimen (HTR). Primary outcomes were Constant Score (CS) and Shoulder Rating Questionnaire (SRQ) from baseline and 6 months after completed training. Results were analyzed according to intention-to treat principles. The study was retrospectively registered in ClinicalTrials.gov. Date of registration: 07/06/2021. Identification number: NCT04915430. Results CS improved by 22.7 points for the STR group and by 23,7 points for the HTR (p = 0.0001). The SRQ improved by 17.7 and 18.1 points for the STR and the HTR groups respectively (p = 0.0001). The inter-group changes were non-significant. All secondary outcomes (passive and active range of motion, pain on impingement test, and resisted muscle tests) improved in both groups, without significant inter-group difference. Conclusion We found no significant difference between a comprehensive supervised training regimen including heavy training principles, and a home-based training program in patients with SIS.

Effect of therapeutic kinesio-taping in patients with shoulder impingement syndrome: A pilot study

Kinesio-taping is widely used in sports rehabilitation for prevention and treatment of sports-related injuries. The role of Kinesio-taping has recently received renewed interest in patients with shoulder problems like shoulder impingement or rotator cuff tendinopathy.This pilot study was undertaken to check the effect of therapeutic kinesio-taping versus placebo kinesio-taping on shoulder pain, acromio-humeral distance (AHD), mobility and disability in patients with shoulder impingement syndrome.8 patients diagnosed with shoulder impingement syndrome were included in the study and they were allocated into the experimental and control group. The patients in experimental group received ultrasound therapy for 8 minutes followed by application of therapeutic kinesio-taping and in control group patients received ultrasound therapy for 8 minutes followed by application of placebo kinesio-taping. Outcome measure were pain intensity by NPRS, shoulder range of motion by goniometry, acromio-humeral distance (AHD) using ultrasonography and functional disability by SPADI assessed at baseline, immediate after taping application and 3 days post intervention. Data analyzed with Kruskal-Wallis H test and p value less than 0.05 consider as significant.Therapeutic kinesio-taping group showed significant change in AHD (p=0.04), pain.(p=0.0001), shoulder range of motion including abduction (p=0.04), internal rotation (p=0.001) and functional disability (0.04), whereas placebo kinesio-taping showed no significant improvement in outcomes. Therapeutic kinesio-taping found to be effective in increasing AHD, range of motion, decreasing pain and functional disability when compare with placebo kinesio-taping. It can be used as adjunct treatment option in patient with shoulder impingement.

How do people perceive different labels for rotator cuff disease? A content analysis of data collected in a randomised controlled experiment

ObjectivesExplore how people perceive different labels for rotator cuff disease in terms of words or feelings evoked by the label and treatments they feel are needed.SettingWe performed a content analysis of qualitative data collected in a six-arm, online randomised controlled experiment.Participants1308 people with and without shoulder pain read a vignette describing a patient with rotator cuff disease and were randomised to one of six labels: subacromial impingement syndrome, rotator cuff tear, bursitis, rotator-cuff-related shoulder pain, shoulder sprain and episode of shoulder pain.Primary and secondary outcomesParticipants answered two questions (free-text response) about: (1) words or feelings evoked by the label; (2) what treatments they feel are needed. Two researchers iteratively developed coding frameworks to analyse responses.Results1308/1626 (80%) complete responses for each question were analysed. Psychological distress (21%), uncertainty (22%), serious condition (15%) and poor prognosis (9%) were most often expressed by those labelled with subacromial impingement syndrome. For those labelled with a rotator cuff tear, psychological distress (13%), serious condition (9%) and poor prognosis (8%) were relatively common, while minor issue was expressed least often compared with the other labels (5%). Treatment/investigation and surgery were common among those labelled with a rotator cuff tear (11% and 19%, respectively) and subacromial impingement syndrome (9% and 10%) compared with bursitis (7% and 5%).ConclusionsWords or feelings evoked by certain labels for rotator cuff disease and perceived treatment needs may explain why some labels drive management preferences towards surgery and imaging more than others.