The Effect of Humeral Head Depressor Strengthening in Individuals With Subacromial Impingement Syndrome

Subacromial Impingement Syndrome (SIS) is one of the most common musculoskeletal problems in the shoulder joint. This study aimed to investigate the effectiveness of a rehabilitation program targeting humeral head depressor muscles on symptoms in individuals with SIS.Participants were randomly divided into study and control groups.Volunteers who complained of shoulder pain for more than a month, who had limitation in passive movement compared to the other side shoulder, who had Neer impingement test, Hawkins test, Jobe supraspinatus test, and who were able to com-municate were included in the study. Individuals 1) Having any neurological condition affecting the upper extremity, 2) having neurological findings related to cervical disc herniation, 3) having a full-thickness rupture of one of the rotator cuff tendons, 4) having calcific tendonitis, 5) having undergone previous shoulder surgery and 6) Physical therapy-rehabilitation for the shoulder with the same complaints in the last 6 months, or 7) receiving corticosteroid injection were excluded from the study. While the control group received standard physical therapy and rehabilitation, the study group underwent a progressive resistance exercise program to strengthen the humeral head depressors and peri-articular muscles, including the rotator cuff. Acromio-humeral distance (AHD) and tendon thickness measurements were evaluated by ultrasonography, while pain intensity was measured through VAS and McGill Questionnaire, upper extremity disability through DASH-T, and kinesiophobia through Fear Avoidance Beliefs Questionnaire, respectively.