The effectiveness of scapular stabilization and rotator cuff training in patients with subacromial impingement syndrome.
This study will be a randomized controlled trial comparing two different forms of exercise therapy. The independent variable wil be two types of exercise. One group will be assigned a specific rotator cuff training regimine and the other will be assigned a scapular stabilization regimine. The progresssion for both groups will be provided by increased theraband resistance. Compliance to the home exercise program will be assessed using a daily log. Subjects will be assessed at baseline, 4, 8, and 16 weeks post-intervention.
The exercises in both groups are standard rehabilitation activities for this diagnosis. In addition, all patient will receive standardized physical therapy intervention to treat subacromial impingement sydnrome (standard of care) consisting of manual therapy to the entire upper quarter, flexibility exercises, and usual medical advice.
The dependent varaibles assessed at baseline, 4, 8 and 16 weeks will include:
1) Numerical pain rating scale during scapular plane shoulder elevation.
2) Functional Outcome Score: American Shoulder and Elbow (ASES) questionnaire.
3) Patient’s Global Rating of Change (15 point ordinal scale ranging from -7 to +7)
4) Patient self-reported global % of improvement
5) Pain Behavior Assessmenton the Tampa Scale for Kinesiophobia
Statistical Analysis: Unpaired t or chi-square tests on all pre-op demographic data. Same statistical analysis on all post-operative dependent variables between groups.
1) 18-80 years of age
2) Neer Stage I/II with primary pain complaint in the shoulder and/or upper arm
3) Presence of at least two of the following findings: painful arc, weakness in ER, + impingement test (Hawkins/Kennedy or Neer/Walsh), and pain and/or weakness with resistance to internal rotation, external rotation, or scapular plane elevation.