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.

Stretching Exercises for Subacromial Impingement Syndrome: Effects of 6-Week Program on Shoulder Tightness, Pain, and Disability Status

2018 ◽  
Vol 27 (2) ◽  
pp. 132-137 ◽  
Author(s):  
Elif Turgut ◽  
Irem Duzgun ◽  
Gul Baltaci
Keyword(s):  
Impingement Syndrome ◽  
Pain Severity ◽  
Posterior Capsule ◽  
Subacromial Impingement Syndrome ◽  
Subacromial Impingement ◽  
Disability Score ◽  
Pectoralis Minor ◽  
Significant Difference ◽  
Disability Status ◽  
Stretching Exercises

Context: Increasing soft tissue flexibility and joint mobility is one of the important aims of studies to treat subacromial impingement syndrome (SIS). Objective: The aim of this study was to investigate the effects of a stretching program on posterior capsule tightness, pectoralis minor tightness, pain severity, and disability status in SIS. Design: Single-group pretest posttest design. Setting: University outpatient clinic. Participants: 18 participants diagnosed with SIS (34.8±9.4 y, symptoms duration 5.8±4.9 months) were included in the study. Intervention: The 6-week self-stretching program for pectoralis minor, posterior capsule, levator scapula, and latissimus dorsi was performed. Main Outcome Measures: Posterior capsule tightness, pectoralis minor tightness, pain severity (visual analog scale), and self-reported shoulder-related pain and disability status (Shoulder Pain and Disability Index) were used to assess changes in flexibility and symptoms. Results: Comparisons showed that there was significantly less posterior capsule and pectoralis minor tightness, less pain severity on activity and at night, and a lower disability score reported after the 6-week stretching program (P < 0.05). There was no statistically significant difference in pain severity at rest after the 6-week stretching program (P > 0.05). Conclusions: The findings of the study showed that flexibility, pain severity, and disability gains can be achieved with a 6-week stretching exercise training for participants with SIS. Therefore, shoulder girdle stretching exercises should be recommended early in shoulder rehabilitation program.

scholarly journals To explore the reasonable selection of clavicular hook plate to reduce the occurrence of subacromial impingement syndrome after operation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Rui Qiao ◽  
Jiarui Yang ◽  
Kun Zhang ◽  
Zhe Song
Keyword(s):  
Impingement Syndrome ◽  
Hook Plate ◽  
Subacromial Impingement Syndrome ◽  
Control Group ◽  
Shoulder Abduction ◽  
Acromioclavicular Joint Dislocation ◽  
Subacromial Impingement ◽  
Significant Difference ◽  
Clavicular Hook Plate ◽  
The Difference

Abstract Background Acromioclavicular joint dislocation is a shoulder joint injury common in the clinical setting and is generally surgically treated with clavicular hook plate technique with confirmed curative effect. However, symptoms such as shoulder abduction limitation, shoulder discomfort and joint pain postoperatively may occur in some patients. Therefore, this study aimed to explore whether the existing clavicular hook plate can be reasonably selected to reduce the incidence of subacromial impingement syndrome (SIS) and provide a reference for clinical diagnosis and treatment. Materials and methods Patients with SIS admitted from March 2018 to June 2020 were selected as the experimental group and asymptomatic patients postoperatively, as the control group. The hook end depth and acromial height of the hook plate used in patients were recorded, and the difference between them was calculated. Results The difference between the hook plate depth and acromial height was 7.500±1.912 mm and 6.563±1.537 mm in the experimental and control groups, respectively, with statistically significant difference (t=3.021, P=0.006). A difference of >0.6 mm as a grouping index is required to perform a single factor analysis, with statistically significant difference (t=3.908, P=0.048). Conclusions The occurrence of SIS after placing the clavicular hook plate may be related to the difference between its depth and the acromial height. A difference of >6 mm may be a factor affecting the occurrence of SIS. Pre-imaging measurement of the acromial height can provide suggestions for selecting the type of hook plate intraoperatively.

scholarly journals Impingement on the internet: evaluating the quality and readability of online subacromial impingement information

2021 ◽  
Vol 7 (4) ◽  
pp. e001203
Author(s):  
Christopher Erian ◽  
Michael Erian ◽  
Sumit Raniga
Keyword(s):  
Pearson Correlation ◽  
Poor Quality ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
The Internet ◽  
Online Information ◽  
Subacromial Impingement ◽  
Significant Difference ◽  
Government Websites ◽  
News Outlet

Patients increasingly access the internet to learn about their orthopaedic conditions. Despite this, online information may be unregulated, of questionable quality and difficulty to read.ObjectivesTherefore, this study aimed to evaluate the readability and quality of the online information concerning subacromial impingement syndrome.MethodsA search using Australia’s three most popular online search engines was undertaken using the search terms ‘subacromial impingement syndrome’ and ‘shoulder impingement’. The first 15 websites for each term were evaluated. Duplicates, advertisements and sponsored links were removed.The quality and readability of each website were calculated using the DISCERN and Flesch-Kincaid Reading Ease (FKRE) tools, respectively. The differences in quality and readability between each website type (healthcare/academic, commercial, news outlet, charitable/not-for-profit, layperson, government) was assessed using analysis of variance. The correlation between quality and readability was assessed using the Pearson correlation coefficient.ResultsThe majority of 35 unique websites analysed were of ‘poor’/’fair’ quality (determined via the DISCERN instrument) and ‘difficult’ readability (per the FKRE tool), with no correlation established between the scores. There was no statistically significant difference in quality across website types, however layperson, news outlet and government websites were found to be significantly more readable than alternate website categories (p<0.05).ConclusionsWe determined that much of the online information concerning subacromial impingement syndrome may be difficult to read and/or of poor quality. By recognising the shortcomings of information accessed by patients online, it is hoped clinicians may be prompted to better educate their patients.

scholarly journals Effects of eccentric exercise in patients with subacromial impingement syndrome: a systematic review and meta-analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Robin Larsson ◽  
Susanne Bernhardsson ◽  
Lena Nordeman
Keyword(s):  
Systematic Review ◽  
Eccentric Exercise ◽  
Meta Analysis ◽  
Post Treatment ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Cochrane Library ◽  
Subacromial Impingement ◽  
Significant Difference ◽  
Meta Analyses

Abstract Background Subacromial impingement syndrome is a common problem in primary healthcare. It often include tendinopathy. While exercise therapy is effective for this condition, it is not clear which type of exercise is the most effective. Eccentric exercises has proven effective for treating similar tendinopathies in the lower extremities. The aim of this systematic review was therefore to investigate the effects of eccentric exercise on pain and function in patients with subacromial impingement syndrome compared with other exercise regimens or interventions. A secondary aim was to describe the included components of the various eccentric exercise regimens that have been studied. Methods Systematic searches of PubMed, Cochrane Library and PEDro by two independent authors. Included studies were assessed using the PEDro scale for quality and the Cochrane scale for clinical relevance by two independent authors. Data were combined in meta-analyses. GRADE was applied to assess the certainty of evidence. Results Sixty-eight records were identified. Seven studies (eight articles) were included, six were meta-analysed (n = 281). Included studies were of moderate quality (median PEDro score 7, range 5–8). Post-treatment pain was significantly lower after eccentric exercise compared with other exercise: MD -12.3 (95% CI − 17.8 to − 6.8, I2 = 7%, p < 0.001), but this difference was not clinically important. Eccentric exercise provided no significant post-treatment improvement in function compared with other exercise: SMD -0.10 (95% CI − 0.79 to 0.58, I2 = 85%, p = 0.76). Painful eccentric exercise showed no significant difference compared to pain-free eccentric exercise. Eccentric training regimes showed both similarities and diversity. Intervention duration of 6–8 weeks was almost as effective as 12 weeks. Conclusions Evidence of low certainty suggests that eccentric exercise may provide a small but likely not clinically important reduction in pain compared with other types of exercise in patients with subacromial impingement syndrome. It is uncertain whether eccentric exercise improves function more than other types of exercise (very low certainty of evidence). Methodological limitations of existing studies make these findings susceptible to change in the future. Trial registration PROSPERO CRD42019126917, date of registration: 29-03-2019.

scholarly journals Effects of Modified Posterior Shoulder Stretching Exercises on Shoulder Mobility, Pain, and Dysfunction in Patients With Subacromial Impingement Syndrome

2020 ◽  
Vol 12 (2) ◽  
pp. 139-148
Author(s):  
Özge Tahran ◽  
Sevgi Sevi Yeşilyaprak
Keyword(s):  
Internal Rotation ◽  
Treatment Program ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Control Group ◽  
Subacromial Impingement ◽  
Positive Effects ◽  
Posterior Shoulder ◽  
Significant Difference ◽  
Stretching Exercises

Background: Posterior shoulder stretching exercises (PSSEs) aim to reduce posterior shoulder tightness (PST). Position modification of traditional PSSEs has been suggested to minimize inadequate control of scapular and glenohumeral rotation, possibly leading to increased subacromial impingement. Hypothesis: Modified PSSEs will have positive effects on shoulder mobility, pain, and dysfunction. Study Design: Randomized controlled trial. Level of Evidence: Level 1. Methods: A total of 67 symptomatic patients with subacromial impingement syndrome (SIS) and shoulder internal rotation asymmetry were randomly assigned to 3 groups: modified cross-body stretch (MCS) (n = 22; treatment program + MCS), modified sleeper stretch (MSS) (n = 22; treatment program + MSS), and a control group (n = 23; treatment program consisting of only modalities, range of motion [ROM], and strength training but no PSSEs) for 4 weeks. Pain, PST, shoulder rotation ROM, and dysfunction were evaluated. Results: Pain, PST, shoulder rotation ROM, function, and disability improved in all groups ( P < 0.05). The MCS and MSS groups had better results compared with the control group with regard to pain with activity, internal rotation ROM, function, and disability ( P < 0.05). There was no significant difference between the stretching groups ( P > 0.05). Conclusion: All treatments improved pain, shoulder mobility, function, and disability in patients with SIS. However, modified PSSEs in addition to a treatment program was superior to the treatment program alone (without PSSEs) in improving pain with activity, internal rotation ROM, and dysfunction. Moreover, stretching provided clinically significant improvements. Clinical Relevance: Modified PSSEs, in addition to a treatment program, are beneficial for patients with SIS. Both modified cross-body and sleeper stretches are safe and efficacious for improving shoulder mobility, pain, and dysfunction.

Comparison of the Effectiveness of Isometric, Isotonic Eccentric And Isotonic Concentric Exercises in Pain Management

2021 ◽  
Vol 15 (11) ◽  
pp. 2859-2861
Author(s):  
Ishrat Fatima ◽  
Misbah Mustafa ◽  
Muhammad Irfan Fazal ◽  
Afeera Tariq ◽  
Nimra Nadeem ◽  
...  
Keyword(s):  
Rating Scale ◽  
Isometric Exercise ◽  
Post Treatment ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Manual Muscle Testing ◽  
Subacromial Impingement ◽  
Muscle Testing ◽  
Significant Difference ◽  
One Way Anova

Aim: To compare the effect of isometrics, isotonic concentric and isotonic eccentric strengthening techniques on patients diagnosed with subacromial impingement syndrome. Methods: The study design used is randomized clinical trial. 36 patients are allocated in 3 groups with 12 patients in each group with age limit from 30-50 years treated for 6 weeks on alternate days with isometrics, isotonic concentric and isotonic eccentric with baseline exercise plan respectively. Each patient received 18 sessions of exercise plan. Intervention plan is divided into 2 phases, with each phase of 3 weeks. Outcome measuring tools used are Numeric Pain Rating Scale(NPRS) to measure pain, Manual Muscle Testing (MMT) to measure muscle strength was assessed at Day 0, Week3, and Week 6. Result: Results are generated by using SPSS 21. Post treatment ONE WAY ANOVA showed no significant difference in reduction of pain assessed by NPRS in GROUP1 treated with isometric exercise plan and GROUP2 & GROUP3 treated with isotonic eccentric and isotonic concentric exercise plan respectively. Post treatment One way anova showed p value .117 which is greater than 0.05. Post treatment ONE WAY ANOVA showed significant difference for strength of all the rotator cuff muscles. Conclusion: Isometric exercise plan conclusively proved to be better as compared to isotonic eccentric and isotonic concentric program in strengthening of patients with subacromial impingement syndrome. Keywords: Subacromial Impingement Syndrome, Isometric, Isotonic Eccentric, Isotonic Concentric.

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).

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