Training in Subacromial Impingement Syndrome
- Conditions
- Subacromial Impingement Syndrome
- Interventions
- Other: Training
- Registration Number
- NCT04915430
- Lead Sponsor
- Reumatologiklinikken
- Brief Summary
A randomized controlled trial comparing a comprehensive supervised training regimen with a validated home-based regimen for subacromial impingement syndrome.
- Detailed Description
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.
Randomised control trial with blinded assessor. 126 consecutive patients with subacromial impingement syndrome 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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 126
- Subacromial impingement syndrome
- Ongoing claim with the Labour market insurance, insurance company or comparable institution.
- Ongoing application for job revalidation or health related pension.
- Radiating neck pain.
- Ultrasound verified complete rotator cuff tendon lesion, as defined by hypoechoic or anechoic full thickness defect of the tendon, or absence of the tendon.
- Periarthritis humeroscapularis.
- Acute luxation or fracture of the shoulder.
- Ongoing steady analgetic treatment of other concomitant painful condition, unrelated to the patients shoulder problem.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Home training regimen Training The program consisted of the following: * 1 motion exercise: upper trapezius relaxation * 3 strengthening exercises: serratus anterior strengthening exercise, humeral external rotation with the arm at the side of the body, and humeral external rotation with a rubber band and the arm at 90 degrees abduction. * 2 stretching exercises: posterior shoulder and pectoralis minor stretching, Exercises were performed daily, with weekly progression. Supervised training regimen Training This training regimen consisted of 3 phases: the 1st focused on restoring motion, the 2nd on strengthening of the rotator cuff muscles, and the 3rd on strengthening of the scapular muscles. Stretching completed every training session. * Motion training consisted of 6 exercises. * Postural training: shoulder shrugs and shoulder retraction exercises. * Glenohumeral training: pendulum exercises, and active assisted flexion, abduction and external rotation. * Strengthening of the rotator cuff: side lying external rotation, internal rotation and scaption. * Strengthening of the scapular muscles: press-up, push-up with a plus, serratus anterior supine punch, standing rowing (low row), and seated rowing (high row). * Training sessions ended with 4 stretches: anterior shoulder stretch, posterior shoulder stretch, inferior capsular stretch, sleepers stretch. Exercises were performed 3 times a week, with progression after the 1st week, and thereafter every 2nd week.
- Primary Outcome Measures
Name Time Method Shoulder constant score 6 months after ended training Functional assessment of the shoulder
Shoulder Rating Questionnaire 6 months after ended training Self-administered questionnaire
- Secondary Outcome Measures
Name Time Method Neer test 6 months after ended training Stabilization of the patient's scapula with one hand, while passively flexing the arm while it is internally rotated. If the patient reports pain in this position, then the result of the test is considered to be positive (rated positive = 1 and negative = 0).
Hawkins test 6 months after ended training Placing the patient's shoulder in 90 degrees of shoulder flexion with the elbow flexed to 90 degrees, and afterwards internally rotating the arm. The test is considered to be positive if the patient experiences pain with internal rotation (rated positive = 1 and negative = 0).
Passive motion 6 months after ended training Shoulder flexion, measurement in degrees; Shoulder abduction, measurement in degrees; Shoulder internal rotation, measurement in degrees; Shoulder external rotation, measurement in degrees.
Active motion 6 months after ended training Shoulder flexion, measurement in degrees; Shoulder abduction, measurement in degrees; Shoulder internal rotation, measurement in degrees; Shoulder external rotation, measurement in degrees.
Visual Analogue Scale 6 months after ended training Measurement of pain on a 10 cm scale, where 0 indicates no pain, and 10 worst pain for the following muscle tests: full can test, empty can test, lift off test, resisted external rotation, palm-up test, Yergason´s test.