Efficacy of Proprioceptive Exercises in Patients with Subacromial Impingement Syndrome

Dilek, Banu; Gülbahar, Selmin; Gundogdu, Mehtap; Ergin, Burcu; Manisalı, Metin; Özkan, Mustafa; Akalin, Elif

doi:10.1097/phm.0000000000000327

Cited by 56 publications

(101 citation statements)

References 42 publications

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“…Both Dilek et al (2015) and Naughton et al (2005) found the JPS improved after exercise training in the patients with shoulder impingement syndrome and patients with shoulder posterior dislocation. Therefore, because chronic pain and effusion may influence JPS centrally and peripherally (Röijezon et al, 2015), by reducing pain and decreasing symptoms with exercises (Littlewood, Ashton, Chance-Larsen, May, & Sturrock, 2012), JPS may be restored in patients with shoulder injuries.…”

Section: Discussionmentioning

confidence: 97%

Exercises focusing on rotator cuff and scapular muscles do not improve shoulder joint position sense in healthy subjects

Lin

Karduna

2016

Human Movement Science

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Proprioception is essential for shoulder neuromuscular control and shoulder stability. Exercise of the rotator cuff and scapulothoracic muscles is an important part of shoulder rehabilitation. The purpose of this study was to investigate the effect of rotator cuff and scapulothoracic muscle exercises on shoulder joint position sense. Thirty-six healthy subjects were recruited and randomly assigned into either a control or training group. The subjects in the training group received closed-chain and open-chain exercises focusing on rotator cuff and scapulothoracic muscles for four weeks. Shoulder joint position sense errors in elevation, including the humerothoracic, glenohumeral and scapulothoracic joints, was measured. After four weeks of exercise training, strength increased overall in the training group, which demonstrated the effect of exercise on the muscular system. However, the changes in shoulder joint position sense errors in any individual joint of the subjects in the training group were not different from those of the control subjects. Therefore, exercises specifically targeting individual muscles with low intensity may not be sufficient to improve shoulder joint position sense in healthy subjects. Future work is needed to further investigate which types of exercise are more effective in improving joint position sense, and the mechanisms associated with those changes.

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Section: Discussionmentioning

confidence: 97%

Exercises focusing on rotator cuff and scapular muscles do not improve shoulder joint position sense in healthy subjects

Lin

Karduna

2016

Human Movement Science

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“…Measured before and after intervention.Pain:VASROM: GoniometerStrength: Hand held dynamometerFunction and QoL: WORC.Clinical tests: Joint Position Sense and Lateral Scapular Slide TestPatients outcomes improved statistically in both groups ( P < 0.05).No significant difference between groups in all parameters ( P > 0.05) except muscle strength for lower trapezius and supraspinatus and clinical tests ( P < 0.05).Comments: Missing P -values and CI in results section. No protocol registered.Low risk:RandomizationDrop-out rateIntention-to-treatUnclear risk:AllocationComplianceHigh risk:Other bias (sample size)High risk (downgrade 1)ModerateDilek 2016 [57]Randomized using block randomization. n = 63, 21 male, 42 women. 25 – 65 years.…”

Section: Resultsmentioning

confidence: 99%

“…For crossover trials only data from the first period were included [53]. The outcomes measures of pain during movement and function were found comparable across five studies [53–57]. The function scoring scales were reversed in two studies [55, 57] for the adequate interpretation and to enable meta-analysis of the data.…”

Section: Methodsmentioning

confidence: 99%

“…The outcomes measures of pain during movement and function were found comparable across five studies [53–57]. The function scoring scales were reversed in two studies [55, 57] for the adequate interpretation and to enable meta-analysis of the data. To ease interpretation the function scores in two studies were converted to 0–100 [56, 57] and in one study the pain scores were converted to 0–10 [56].…”

Section: Methodsmentioning

confidence: 99%

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Specific or general exercise strategy for subacromial impingement syndrome–does it matter? A systematic literature review and meta analysis

Shire

Stæhr

Overby

et al. 2017

BMC Musculoskelet Disord

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BackgroundExercise is frequently suggested as a treatment option for patients presenting with symptoms of subacromial impingement syndrome. Some would argue implementing a specific exercise strategy with special focus on correction of kinematic deficits would be superior to general exercise strategy. There is however a lack of evidence comparing such exercise strategies to determine which is the most effective in the treatment of subacromial impingement syndrome. The aim of this review is to evaluate whether implementing specific exercise strategies involving resistive exercises are more effective than a general exercise strategy for the treatment of patients with subacromial impingement syndrome.MethodsRandomized controlled trials were identified through an electronic search on PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science and PEDro. In addition, article reference lists and Clinicaltrials.gov were searched. Studies were considered eligible if they included interventions with resistive specific exercises as compared to general resistance exercise. Four reviewers assessed risk of bias and methodological quality guided by Cochrane recommendations. Results were synthesised qualitatively or quantitatively, where appropriate.ResultsSix randomized controlled trials were included with 231 participants who experienced symptoms of subacromial impingement syndrome. Four studies evaluated the effectiveness of specific scapular exercise strategy and two studies evaluated the effectiveness of specific proprioceptive strategy. Five studies were of moderate quality and one study was of low quality. No consistent statistical significant differences in outcomes between treatment groups were reported in the studies. Standardized mean difference (SMD) for pain was SMD −0.19 (95% CI −0.61, 0.22) and SMD 0.30 (95% CI −0.16, 0.76) for function.ConclusionsThere is insufficient evidence to support or refute the effectiveness of specific resistive exercise strategies in the rehabilitation of subacromial impingement syndrome. More high quality research is needed to accurately assess this. This review provides suggestions on how to improve the methodological design of future studies in this area.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1518-0) contains supplementary material, which is available to authorized users.

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“…39 The results in our study are similar to those reported in the treatment with proprioceptive exercises and conventional physiotherapy. 40 …”

Section: Discussionmentioning

confidence: 99%

A Preliminary Randomized Clinical Trial on the Effect of Cervicothoracic Manipulation Plus Supervised Exercises vs a Home Exercise Program for the Treatment of Shoulder Impingement

Vinuesa-Montoya

Aguilar‐Ferrándiz

Matarán-Peñarrocha

et al. 2017

Journal of Chiropractic Medicine

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Objective: The purpose of this study was to investigate changes in pain, disability, and range of movement after cervicothoracic manipulation plus exercise therapy in individuals with unilateral shoulder impingement syndrome. Methods: Forty-one patients (30 men, 11 women; aged 47 ± 9) diagnosed with unilateral shoulder impingement syndrome attended 10 sessions for 5 weeks (2 sessions/wk). Eligible patients were randomly allocated to 2 study groups: cervicothoracic manipulation plus exercise therapy (n = 21) or home exercise program (n = 20). The outcomes measures included the visual analog scale (VAS); the Disabilities of the Arm, Shoulder, and Hand score; Shoulder Disability Questionnaire; subacromial impingement syndrome (Hawkins-Kennedy Test and Neer Test); and shoulder active range of motion (movements of flexion, extension, rotation, adduction, and abduction). Assessments were applied at baseline and 24 hours after completing 5 weeks of related interventions. Results: After 5 weeks of treatment significant between-group differences were observed in the Disabilities of the Arm, Shoulder, and Hand score (P = .012); however, no statistically significant differences were achieved for Shoulder Disability Questionnaire (P = .061) and pain intensity (P = .859). Both groups improved with regard to disability and clinical tests for detecting subacromial impingement syndrome. Conclusions: This clinical trial suggests that cervicothoracic manipulative treatment with mobilization plus exercise therapy may improve intensity of pain and range of motion compared with the home exercise group alone; the home exercise group had significant changes for flexion, extension, adduction, and abduction, but not for external and internal rotation movement in patients with shoulder impingement. (J Chiropr Med 2017;16:85-93)

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Efficacy of Proprioceptive Exercises in Patients with Subacromial Impingement Syndrome

Abstract: Although proprioceptive exercises may provide better proprioceptive acuity, no additional positive effect on other clinical parameters was observed.

Cited by 56 publications

References 42 publications

Exercises focusing on rotator cuff and scapular muscles do not improve shoulder joint position sense in healthy subjects

Exercises focusing on rotator cuff and scapular muscles do not improve shoulder joint position sense in healthy subjects

Specific or general exercise strategy for subacromial impingement syndrome–does it matter? A systematic literature review and meta analysis

A Preliminary Randomized Clinical Trial on the Effect of Cervicothoracic Manipulation Plus Supervised Exercises vs a Home Exercise Program for the Treatment of Shoulder Impingement

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