scholarly journals Subacromial impingement syndrome: association of multiple magnetic resonance imaging parameters with shoulder function and pain

2021 ◽  
Author(s):  
Malte Jäschke ◽  
Hans-Christian Köhler ◽  
Marc-André Weber ◽  
Thomas Tischer ◽  
Claudia Hacke ◽  
...  
Keyword(s):  
Constant Score ◽  
Biceps Tendon ◽  
Shoulder Function ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Subacromial Impingement ◽  
Resonance Imaging ◽  
Halo Sign ◽  
Subacromial Spur ◽  
Shoulder Angle

Abstract Introduction Shoulder pain is one of the most common complaints in orthopaedics. This study focusses on the relationship between shoulder function in subacromial impingement syndrome and imaging criteria in magnetic resonance imaging (MRI). Materials and methods This prospective clinical trial included 69 patients treated for subacromial impingement syndrome. Shoulder function (Constant Score, range of abduction, abduction force) and pain were correlated with the following MRI parameters: tendinosis of the rotator cuff, “halo-sign” around the biceps tendon, subacromial distance, critical shoulder angle, size of subacromial osteophytic spurs and maximum width of subacromial and subdeltoid bursa. Statistical analyses included Pearson’s and Spearman’s coefficients of correlation, multiple regression analysis and Student’s t-test. Results The Constant Score was correlated positively with the critical shoulder angle (r = 0.313; p = 0.009) and inversely with a “halo-sign” around the biceps tendon (rho =  −0.384; p = 0.001). There was no significant correlation between spur size and shoulder function, but the size of the subacromial and subdeltoid bursae was positively correlated with the subacromial spur’s size (subacromial bursa: coronal plane: r = 0.327; p = 0.006; sagittal view: r = 0.305; p = 0.011; subdeltoid bursa coronal view: r = 0.333 p = 0.005). The width of the subdeltoid bursa in coronal plane was positively correlated with shoulder pain (r = 0.248; p = 0.004) and negatively with the range of abduction (r =  −0.270; p = 0.025), as well as the mean (r =  −0.332; p = 0.005) and maximum (r =  −0.334; p = 0.005) abduction force. Conclusions Shoulder function and pain in subacromial impingement are best predicted by the width of the subdeltoid bursa measured in the coronal MRI plane as an indicator of bursitis as well as the presence of a “halo-sign” around the biceps tendon indicating glenohumeral joint effusion. Presence of a subacromial spur could lead to subacromial and subdeltoid bursitis, which impairs shoulder function. Shoulder function seems not to be compromised by the presence of a subacromial spur in absence of bursitis. This study was registered at the German Clinical Trials Register on 08 February 2013 (ID: DRKS00011548).

scholarly journals Effect of corticosteroid injections versus physiotherapy on pain, shoulder range of motion and shoulder function in patients with subacromial impingement syndrome: A systematic review and meta-analysis

2016 ◽  
Vol 72 (1) ◽  
Author(s):  
Marlette Burger ◽  
Carly Africa ◽  
Kara Droomer ◽  
Alexa Norman ◽  
Chloé Pheiffer ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Meta Analysis ◽  
Shoulder Function ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Subacromial Impingement ◽  
Shoulder Range Of Motion ◽  
Ebsco Host ◽  
Shoulder Range ◽  
Corticosteroid Injections

Background: Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain. Limited research has been conducted into the efficacy of corticosteroid injections (CSIs) compared to physiotherapy in the management of SIS.Objective: To critically appraise and establish the best available evidence for the effectiveness of CSI in comparison with physiotherapy for the management of pain, shoulder range of motion (ROM) and shoulder function in patients with SIS.Methodology:  Seven databases were searched from inception to February 2016, namely PubMed, Science Direct, EBSCO Host: SPORTDiscus, EBSCO Host: CINAHL, Cochrane, Scopus and PEDro. The main search terms were shoulder impingement syndrome and/or subacromial impingement syndrome, corticosteroid injections and/or steroid injections, physical therapy and/or physiotherapy. Only randomised controlled trials (RCTs) were considered for inclusion. The articles were appraised according to the PEDro scale. The Revman© Review Manager Software was used to combine the results of shoulder function and the data were illustrated in forest plots.Results: The PEDro scores of the three RCTs that qualified for this review ranged from 7 to 8/10. There is Level II evidence suggesting that besides a significant improvement in shoulder function in favour of CSI at 6–7 weeks follow-up (p < 0.0001), no evidence was found for the superiority of CSIs compared with physiotherapy for pain, ROM and shoulder function in the short- (1–3 months), mid- (6 months) and long term (12 months).Conclusion: In patients with SIS only a short term significant improvement in shoulder function was found in favour of CSIs.

scholarly journals Effects of Thoracic Mobilization and Extension Exercise on Thoracic Alignment and Shoulder Function in Patients with Subacromial Impingement Syndrome: A Randomized Controlled Pilot Study

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 316
Author(s):  
Shin Jun Park ◽  
Seok Hyeon Kim ◽  
Soon Hee Kim
Keyword(s):  
Pilot Study ◽  
Thoracic Kyphosis ◽  
Muscle Tone ◽  
Shoulder Function ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Combination Group ◽  
Subacromial Impingement ◽  
Joint Mobilization ◽  
Medial Rotation

Introduction: Thoracic kyphosis commonly occurs in subacromial impingement syndrome. This pilot study investigated the effect of thoracic joint mobilization and extension exercise on improving thoracic alignment and shoulder function. Methods: In total, 30 patients with subacromial impingement syndrome were recruited and randomly assigned to three groups, the joint mobilization group (n = 10), exercise group (n = 10), and combination group (n = 10). After four weeks of treatment, the measured outcomes included thoracic kyphosis using a manual inclinometer; pectoralis major (PM) and upper trapezius (UT) muscle tone and stiffness using the MyotonPRO®; affected side passive range of motion (ROM) using the goniometer (flexion, abduction, medial rotation, and lateral rotation); and shoulder pain and disability index (SPADI). Results: All three groups had significant improvements in all variables (p < 0.05). Thoracic kyphosis; UT muscle tone; and flexion, medial rotation, and lateral rotation ROM and SPADI were all significantly improved in the combination group compared to the mobilization and exercise groups (p < 0.05). Conclusions: The combination therapy of thoracic mobilization and extension exercise can be regarded as a promising method to improve thoracic alignment and shoulder function in patients with subacromial impingement syndrome.

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

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Pierre Schydlowsky ◽  
Marcin Szkudlarek ◽  
Ole Rintek Madsen
Keyword(s):  
Training Program ◽  
Constant Score ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Randomised Control Trial ◽  
Subacromial Impingement ◽  
Supervised Training ◽  
Home Based ◽  
Significant Difference ◽  
Heavy Training

Abstract 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.

scholarly journals Physiotherapy Rehabilitation in Subjects Diagnosed with Subacromial Impingement Syndrome Does Not Normalize Periscapular and Rotator Cuff Muscle Onset Time of Activation

2021 ◽  
Vol 18 (17) ◽  
pp. 8952
Author(s):  
Silvia Ortega-Cebrián ◽  
Monserrat Girabent-Farrés ◽  
Rodney Whiteley ◽  
Caritat Bagur-Calafat
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Onset Time ◽  
Shoulder Function ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Subacromial Impingement ◽  
Prospective Longitudinal Study ◽  
Physiotherapy Program ◽  
Prospective Longitudinal

Clinicians suggest that rehabilitation of Subacromial Impingement Syndrome (SIS) should target improving movement patterns to ensure better clinical outcomes. Understanding changes in onset time of activation patterns and associated changes in clinical outcomes could improve our understanding of rehabilitation strategies. In this prospective longitudinal study, we examined neuromuscular firing patterns and clinical features before and after a standardized physiotherapy program in subjects diagnosed with SIS. Electromyography (EMG) recordings of eleven shoulder muscles were taken at the initial and discharge consultation in 34 male volunteers diagnosed with SIS. EMG recording was performed during flexion, scaption, and abduction at slow, medium, and fast speeds with a loaded (3 kg) and unloaded arm, as well as rotational motion, rotational strength, pain, and shoulder function. Completion of standardized shoulder physiotherapy program for SIS resulted in improvements in clinical outcomes. Resulted showed inconsistent differences of onset time of activation mainly in some of the periscapular muscles for all movements. No differences were seen on the EMG recordings for rotator cuff muscles. Differences in range of motion, strength and function were shown. Despite some changes in onset time of activation, this study was not able to demonstrate consistent changes of onset time of activation of the periscapular and rotator cuff muscles.

THE DIAGNOSTIC VALUE OF MAGNETIC RESONANCE IMAGING IN SUBACROMIAL IMPINGEMENT SYNDROME

2021 ◽  
Vol 62 (6) ◽  
Author(s):  
Dang Bich Nguyet ◽  
Nguyen Tien Long ◽  
Bui Van Lenh ◽  
Nguyen Quang Trung
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Subacromial Impingement ◽  
Resonance Imaging ◽  
Cuff Tear

The retrospective study was performed on 45 patients with subacromial impingement syndrome who underwent magnetic resonance imaging (MRI) which then were compared with the results of their arthroscopy. Results: 95.2% out of the cases were found to have type II and III acromion morphology; 73.8% had subacromial enthesophyte spurs; 66.7% had subacromial bursitis; 97.6% showed lesions of supraspinatus tendons in which partial–thickness rotator cuff tear was the most commonly seen. MRI showed a sensitivity (Sn) of 91.6%, specificity (Sp) of 72.2%, positive predictive value (PPV) of 81.4%, negative predictive value (NPV) of 86.67% in diagnosing subacromial bursitis. For partial-thickness rotator cuff tear, it showed a Sn of 92.5%, Sp of 93.3%, PPV of 96.1%, NPV of 87.5%. In evaluation of full-thickness rotator cuff tear, MRI showed a Sn of 100% and Sp of 100%.

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