RESEARCH ARTICLE


The Dose-Response Effect of Medical Exercise Therapy on Impairment in Patients with Unilateral Longstanding Subacromial Pain



Håvard Østerås*, 1, Tom Arild Torstensen2
1 Sør-Trøndelag University College, Faculty of Health Education and Social Work, Department of Physical Therapy, N-7004 Trondheim, Norway
2 Holten Institute, Lidingö, Sweden


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Creative Commons License
© Østerås and Torstensen; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Sør-Trøndelag University College, Faculty of Health Education and Social Work, Department of Physical Therapy, Ranheimsv 10, N-7004 Trondheim, Norway; Tel: +47 73 55 93 05; Fax: +47 73 55 93 51; E-mail: havard.osteras@hist.no


Abstract

Objectives:

The primary aim of this study was to investigate the effect of medical exercise therapy in shoulder impingement patients, along with possible correlations between impairment variables.

Study Design:

A prospective unblended randomized clinical trial.

Methods:

Over four months, 61 participants were randomly assigned into a high-graded exercise therapy group (HD) (n=31) and into a low-graded exercise therapy group (LD) (n=30). Prognostic variables were similar between the groups at baseline. Five (8%) patients dropped out during the treatment period, and another four (6%) dropped out before followup. Pain was a composite score of a visual analogue scale (VAS). Isometric strength was measured during four resisted break tests on the shoulder. Function was measured by means of a functional assessment questionnaire (Shoulder Rating Questionnaire, SRQ). Both groups trained three times per week for twelve weeks, with tests pre- and posttraining and six months follow-up.

Results:

The HD group achieved significantly (p < 0.05) better outcome effects than the LD group for pain, range of motion, isometric functional strength and function, but both groups increased function from pretest to posttest.

Conclusions:

In patients with uncomplicated subacromial pain syndrome, medical exercise therapy is an efficient treatment alternative, where high-grade doses should be emphasized. A major limitation is that the measurements were not undertaken by another person than the treating physiotherapists.

Keywords: Shoulder, rehabilitation, impingement, physical therapy, dose-response, muscle function..