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Scapular-focused treatment in patients with shoulder impingement syndrome: a randomized clinical trial

F. Struyf & J. Nijs & S. Mollekens & I. Jeurissen & S. Truijen & S. Mottram & R. Meeusen

Setting the scene:

Shoulder impingement syndrome is commonly reported in the general population, and a common cause of disability at work and during daily activities. Impingement syndrome is broadly described as an encroachment of the subacromial tissues as a result of the narrowing of the subacromial space. Changes in scapular positioning and motor control are considered important risk factors for developing shoulder impingement syndrome. The aim of this study was to evaluate the effects of a scapular-focused treatment approach in comparison with a control therapy in patients with shoulder impingement symptoms.

What did they do?

22 participants were randomized into experimental group: scapular-oriented treatment protocol (manual mobilizations, stretching, and motor control training of the scapula with emphasis on a scapular orientation exercise (SOE)) or Control group (eccentric muscle strength training program of the rotator cuff muscles, passive - multidirectional- glenohumeral mobilization, friction massage and ultrasound). Primary outcome measure used was the Shoulder Disability Questionnaire (SDQ). Secondary outcome measures used were Verbal numeric rating scale (for pain) during impingement, Visual analog scale, Forward shoulder posture (acromial distance), Visual observation for tilting and winging, Scapular upward rotation (inclinometry), Scapular motor control (kinetic medial rotation test) and Isometric elevation strength. The results showed A large clinically important effect in self-reported disability and a moderate to large clinically important improvement in pain in favor of experimental group compared to control group. The effects were maintained at three months follow-up.

Takeaway message:

A scapular-focused treatment exercises, scapular mobilizations, and stretching can be effective for reducing pain and disability for patients with shoulder impingement syndrome.

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