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Clinical outcomes following motor control rehabilitation for shoulder impingement

Clinical outcomes following motor control rehabilitation for shoulder impingement
Clinical outcomes following motor control rehabilitation for shoulder impingement
Background: shoulder impingement is the most common pathology of all shoulder pain referrals. Impingement syndrome can cause functional disability and reduce quality of life and may contribute to the development of rotator cuff disease. The aim of the present study was to examine the effects of a motor control based exercise intervention for shoulder impingement patients.

Methods: sixteen young adults with shoulder pain (mean age 24.61.6, range 18-34 years, 11 males) were recruited from the local community. Inclusion criteria were: current shoulder pain severe enough to limit activity for more than one week and impingement signs. Diagnostic ultrasound imaging was used to exclude participants with complete rotator cuff tears. Mean duration of shoulder symptoms was 16 months (range 4-36 months).Physical screening of pain participants was conducted in order to derive a clinical presentation of shoulder impingement using three clinical tests; Hawkins-Kennedy, Neer’s and Painful Arc. A 10 week motor control retraining package was targeted at correcting movement impairments of the scapula by re-educating muscle recruitment. There were two components to the package: 1) Motor control exercises to correct alignment and coordination, which involve a) controlling scapular orientation during active arm movements; b) muscle-specific exercises for trapezius and serratus anterior; 2) Commonly used manual therapy techniques to reduce joint and muscle restrictions. Participants underwent three data collection sessions; pre-intervention, immediately post-intervention and six months post-intervention (13 participants completed post). The and Disability Index (SPADI); other questionnaires included the Disabilities of Arm Shoulder and Hand (DASH), Oxford Shoulder Score (OSS), Short-Form 36 (SF-36), visual analogue scale (VAS) of pain.

Results: the SPADI scores improved on average by 10(7) and 13(6) points at the 10 week and 6 months assessments respectively. These changes were statistically significant (p<0.001) and reachedthe Minimal Clinically Important Difference (MCID). Pain scores on the 10-point VAS also reduced immediately after and 6 months postintervention with a mean reduction of 3.4(1.5) and 4.3(2) respectively. DASH improved by 9.2(10.3) at 10 weeks and 11.8 (6.3) at 6 months, whilst small improvements were also seen in the OSS (4.74) and SF-36 physical scores (3.84.9). Immediately postintervention the physical tests for impingement syndrome were negative for 15/16 participants.

Conclusions: the present findings suggest that a 10 week programme of specific motor control exercises can improve function and pain in young adults with shoulder impingement. Improvements persisted at 6 months but effectiveness in the longer-term needs to be examined and compared with other exercise interventions in a randomized controlled trial involving a wider age range of shoulder impingement patients.

Disclosure statement: ll authors have declared no conflicts of interest
1462-0324
95
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Mottram, Sarah
1d5657d1-cb55-4fc8-9d11-986f551d4ef6
Warner, Martin
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Morrissey, Dylan
bb51199e-fc9a-4024-b19e-4dee2fc7eb76
Gadola, Stephan D.
ef2fa6cf-2ccc-4fea-a7a5-cc03a9d13ab1
Carr, Andrew
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Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Mottram, Sarah
1d5657d1-cb55-4fc8-9d11-986f551d4ef6
Warner, Martin
f4dce73d-fb87-4f71-a3f0-078123aa040c
Morrissey, Dylan
bb51199e-fc9a-4024-b19e-4dee2fc7eb76
Gadola, Stephan D.
ef2fa6cf-2ccc-4fea-a7a5-cc03a9d13ab1
Carr, Andrew
8f4a925e-2ab3-4f0c-ba96-0be6855f1679
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6

Worsley, Peter, Mottram, Sarah, Warner, Martin, Morrissey, Dylan, Gadola, Stephan D., Carr, Andrew and Cooper, Cyrus (2012) Clinical outcomes following motor control rehabilitation for shoulder impingement. Rheumatology, 51, supplement 3, 95.

Record type: Article

Abstract

Background: shoulder impingement is the most common pathology of all shoulder pain referrals. Impingement syndrome can cause functional disability and reduce quality of life and may contribute to the development of rotator cuff disease. The aim of the present study was to examine the effects of a motor control based exercise intervention for shoulder impingement patients.

Methods: sixteen young adults with shoulder pain (mean age 24.61.6, range 18-34 years, 11 males) were recruited from the local community. Inclusion criteria were: current shoulder pain severe enough to limit activity for more than one week and impingement signs. Diagnostic ultrasound imaging was used to exclude participants with complete rotator cuff tears. Mean duration of shoulder symptoms was 16 months (range 4-36 months).Physical screening of pain participants was conducted in order to derive a clinical presentation of shoulder impingement using three clinical tests; Hawkins-Kennedy, Neer’s and Painful Arc. A 10 week motor control retraining package was targeted at correcting movement impairments of the scapula by re-educating muscle recruitment. There were two components to the package: 1) Motor control exercises to correct alignment and coordination, which involve a) controlling scapular orientation during active arm movements; b) muscle-specific exercises for trapezius and serratus anterior; 2) Commonly used manual therapy techniques to reduce joint and muscle restrictions. Participants underwent three data collection sessions; pre-intervention, immediately post-intervention and six months post-intervention (13 participants completed post). The and Disability Index (SPADI); other questionnaires included the Disabilities of Arm Shoulder and Hand (DASH), Oxford Shoulder Score (OSS), Short-Form 36 (SF-36), visual analogue scale (VAS) of pain.

Results: the SPADI scores improved on average by 10(7) and 13(6) points at the 10 week and 6 months assessments respectively. These changes were statistically significant (p<0.001) and reachedthe Minimal Clinically Important Difference (MCID). Pain scores on the 10-point VAS also reduced immediately after and 6 months postintervention with a mean reduction of 3.4(1.5) and 4.3(2) respectively. DASH improved by 9.2(10.3) at 10 weeks and 11.8 (6.3) at 6 months, whilst small improvements were also seen in the OSS (4.74) and SF-36 physical scores (3.84.9). Immediately postintervention the physical tests for impingement syndrome were negative for 15/16 participants.

Conclusions: the present findings suggest that a 10 week programme of specific motor control exercises can improve function and pain in young adults with shoulder impingement. Improvements persisted at 6 months but effectiveness in the longer-term needs to be examined and compared with other exercise interventions in a randomized controlled trial involving a wider age range of shoulder impingement patients.

Disclosure statement: ll authors have declared no conflicts of interest

Full text not available from this repository.

More information

Published date: 2 May 2012
Venue - Dates: British Society of Rheumatology, United Kingdom, 2012-05-02
Organisations: Physical & Rehabilitation Health

Identifiers

Local EPrints ID: 339132
URI: https://eprints.soton.ac.uk/id/eprint/339132
ISSN: 1462-0324
PURE UUID: cb3c3e64-e340-4938-ba5c-049ab8de7b28
ORCID for Peter Worsley: ORCID iD orcid.org/0000-0003-0145-5042
ORCID for Martin Warner: ORCID iD orcid.org/0000-0002-1483-0561
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 24 May 2012 10:27
Last modified: 06 Jun 2018 13:00

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