Individualized Versus General Exercise Therapy in People With Subacromial Pain Syndrome: A Randomized Controlled Trial

Ghazaleh Momeni; Abbas Tabatabaei; Mehrnaz Kajbafvala; Morteza Nakhaei Amroodi; Lincoln Blandford

doi:10.1016/j.apmr.2024.08.027

Individualized Versus General Exercise Therapy in People With Subacromial Pain Syndrome: A Randomized Controlled Trial

Arch Phys Med Rehabil. 2024 Oct 16:S0003-9993(24)01256-5. doi: 10.1016/j.apmr.2024.08.027. Online ahead of print.

Authors

Ghazaleh Momeni¹, Abbas Tabatabaei², Mehrnaz Kajbafvala¹, Morteza Nakhaei Amroodi³, Lincoln Blandford⁴

Affiliations

¹ Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
² Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; Mobility and Falls lab, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS. Electronic address: stabatabaeihalavi@kumc.edu.
³ Department of Orthopedics, Iran University of Medical Sciences, Tehran, Iran.
⁴ Faculty of Sport, Allied Health, and Performance Science, St Mary's University, Twickenham, United Kingdom; Comera Movement Science, Bristol, United Kingdom.

PMID: 39419431
DOI: 10.1016/j.apmr.2024.08.027

Abstract

Objective: To evaluate the effect of individualized exercises based on movement fault (MF) control on pain intensity, and disability in subjects with chronic subacromial pain syndrome (SAPS).

Design: Randomized controlled trial.

Setting: Rehabilitation clinics.

Participants: Thirty-eight participants with chronic SAPS (mean [SD] age, 52.23 (8.47); 60 % women).

Interventions: The participants were randomly allocated to 1 of the intervention groups (individualized exercises based on MFs control test designed to target specific movement faults) or the control group (commonly prescribed general scapular stabilization exercises). Both groups received exercise sessions twice a week for 4 weeks.

Main outcome measures: The primary outcome measures were pain intensity at rest (PR) and during arm raising (PAR) using a visual analog scale. Disability was assessed as a key secondary outcome, including the disabilities of the arm, shoulder, and hand (DASH) questionnaire and the Shoulder Pain and Disability Index (SPADI).

Results: Following completion of all exercise sessions, PAR was significantly lower in the intervention group compared to the control group (mean, 9.17; 95% confidence interval; 0.31-18.03; P=.04), with a large effect size (0.68). The reduction of PAR remained significantly lower in the intervention group than in the control group after 4 months of follow-up (mean, 18.29; 95% confidence intervals [CI], 9.09-27.48; P<.00) with a large effect size (1.27). Disability significantly decreased at 2-month (mean, 14.58, P=.002 on SPADI index; mean, 10.26, P=.006 on DASH index) and 4-month (mean, 19.85, P<.001 on SPADI index; mean, 12.09, P=.001 on DASH index) follow-ups in the intervention group compared to the control group.

Conclusion: Individualized exercises based on MFs control of the shoulder region was accompanied by decreased PAR and disability in subjects with SAPS.

Keywords: Exercise therapy; Pain; Rehabilitation; Shoulder impingement syndrome.