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The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial.

Moezy A, Sepehrifar S, Solaymani Dodaran M - Med J Islam Repub Iran (2014)

Bottom Line: No significant difference was detected in pain reduction between the groups (p=0.576).Apparent changes occurred in scapular rotation and symmetry in both groups but no significant differences were observed between the two groups (respectively; p=0.183, p=0.578).The scapular stabilization based exercise intervention was successful in increasing shoulder range, decreasing forward head and shoulder postures and Pectoralis minor flexibility.

View Article: PubMed Central - HTML - PubMed

Affiliation: 1. PhD, PT, Assistant Professor, Department of Sports Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. azarmoezy@yahoo.com moezy.a@iums.ac.ir.

ABSTRACT

Background: Dysfunction in the kinetic chain caused by poor scapula stabilization can contribute to shoulder injuries and Shoulder Impingement Syndrome (SIS). The purpose of this study was to compare the effectiveness of two treatment approaches scapular stabilization based exercise therapy and physical therapy in patients with SIS.

Methods: The study is a randomized clinical trial in which 68 patients with SIS were randomly assigned in two groups of exercise therapy (ET) and physical therapy (PT) and received 18 sessions of treatment. Pain, shoulders' range of abduction and external rotation, shoulder protraction, scapular rotation and symmetry as well as postural assessment and Pectoralis minor length were evaluated pre and post intervention. The paired-sample t test and the independent sample t test were applied respectively to determine the differences in each group and between two groups.

Results: Our findings indicated significant differences in abduction and external rotation range, improvement of forward shoulder translation and increase in the flexibility of the involved shoulder between the two groups (respectively ; p=0.024, p=0.001, p<0/0001, p<0/0001). No significant difference was detected in pain reduction between the groups (p=0.576). Protraction of the shoulder (p<0.0001), forward head posture (p<0/0001) and mid thoracic curvature (p<0.0001) revealed a significant improvement in the ET group. Apparent changes occurred in scapular rotation and symmetry in both groups but no significant differences were observed between the two groups (respectively; p=0.183, p=0.578).

Conclusion: The scapular stabilization based exercise intervention was successful in increasing shoulder range, decreasing forward head and shoulder postures and Pectoralis minor flexibility.

No MeSH data available.


Related in: MedlinePlus

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Mentions: Exercise therapy intervention-After a brief explanation about the exercises protocol, The ET subjects participated in three supervised exercise sessions per week over a 6-week period (16, 20, 30-32). This exercises protocol consisted of a 10 minute walking warm up on a treadmill (DK city- DX3-B1), flexibility, strengthening, scapular stabilization and postural exercises. The patients were asked to avoid any other exercises and severe daily activities during their treatment. At the first session, the subjects were introduced to the different levels of tubing exercises with Theraband. Therabands (The Hygienic Corp, Akron, Ohio) are color-coded, with each color representing a different resistance. Strength Training with Theraband consisted of exercises for rotator cuffs, scapular retractors, shoulder external rotators (Figs 4, 5), D2- PNF pattern (Fig .6) and Serratus anterior punches (Fig .7). The level of difficulty of exercises was increased based on quality of shoulder motion and perceived intensity of pain. The level of tubing resistance was adjusted accordingly for all subjects throughout the treatment process. At the first session, the ET subjects were asked to do five repetitions of each of the tubing exercises to see if they were too hard or too easy; Then the appropriate Theraband was chosen based on feedback from the subject, observation and palpation of the target muscles by the investigator. Five subjects of the ET group used Tan (Ultrathin), sixteen used yellow (thin), and the remaining subjects used red (medium) Theraband. Each tubing exercise was performed as 3 sets of 10 repetitions with a 60-second rest period between each set. At the end of every week, the subjects were evaluated and progressed to the next higher level of resistance using yellow (thin), red (medium), green (heavy), blue (extra-heavy) and Black (Special Heavy) Therabands according to each subject.


The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial.

Moezy A, Sepehrifar S, Solaymani Dodaran M - Med J Islam Repub Iran (2014)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4301231&req=5

Mentions: Exercise therapy intervention-After a brief explanation about the exercises protocol, The ET subjects participated in three supervised exercise sessions per week over a 6-week period (16, 20, 30-32). This exercises protocol consisted of a 10 minute walking warm up on a treadmill (DK city- DX3-B1), flexibility, strengthening, scapular stabilization and postural exercises. The patients were asked to avoid any other exercises and severe daily activities during their treatment. At the first session, the subjects were introduced to the different levels of tubing exercises with Theraband. Therabands (The Hygienic Corp, Akron, Ohio) are color-coded, with each color representing a different resistance. Strength Training with Theraband consisted of exercises for rotator cuffs, scapular retractors, shoulder external rotators (Figs 4, 5), D2- PNF pattern (Fig .6) and Serratus anterior punches (Fig .7). The level of difficulty of exercises was increased based on quality of shoulder motion and perceived intensity of pain. The level of tubing resistance was adjusted accordingly for all subjects throughout the treatment process. At the first session, the ET subjects were asked to do five repetitions of each of the tubing exercises to see if they were too hard or too easy; Then the appropriate Theraband was chosen based on feedback from the subject, observation and palpation of the target muscles by the investigator. Five subjects of the ET group used Tan (Ultrathin), sixteen used yellow (thin), and the remaining subjects used red (medium) Theraband. Each tubing exercise was performed as 3 sets of 10 repetitions with a 60-second rest period between each set. At the end of every week, the subjects were evaluated and progressed to the next higher level of resistance using yellow (thin), red (medium), green (heavy), blue (extra-heavy) and Black (Special Heavy) Therabands according to each subject.

Bottom Line: No significant difference was detected in pain reduction between the groups (p=0.576).Apparent changes occurred in scapular rotation and symmetry in both groups but no significant differences were observed between the two groups (respectively; p=0.183, p=0.578).The scapular stabilization based exercise intervention was successful in increasing shoulder range, decreasing forward head and shoulder postures and Pectoralis minor flexibility.

View Article: PubMed Central - HTML - PubMed

Affiliation: 1. PhD, PT, Assistant Professor, Department of Sports Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. azarmoezy@yahoo.com moezy.a@iums.ac.ir.

ABSTRACT

Background: Dysfunction in the kinetic chain caused by poor scapula stabilization can contribute to shoulder injuries and Shoulder Impingement Syndrome (SIS). The purpose of this study was to compare the effectiveness of two treatment approaches scapular stabilization based exercise therapy and physical therapy in patients with SIS.

Methods: The study is a randomized clinical trial in which 68 patients with SIS were randomly assigned in two groups of exercise therapy (ET) and physical therapy (PT) and received 18 sessions of treatment. Pain, shoulders' range of abduction and external rotation, shoulder protraction, scapular rotation and symmetry as well as postural assessment and Pectoralis minor length were evaluated pre and post intervention. The paired-sample t test and the independent sample t test were applied respectively to determine the differences in each group and between two groups.

Results: Our findings indicated significant differences in abduction and external rotation range, improvement of forward shoulder translation and increase in the flexibility of the involved shoulder between the two groups (respectively ; p=0.024, p=0.001, p<0/0001, p<0/0001). No significant difference was detected in pain reduction between the groups (p=0.576). Protraction of the shoulder (p<0.0001), forward head posture (p<0/0001) and mid thoracic curvature (p<0.0001) revealed a significant improvement in the ET group. Apparent changes occurred in scapular rotation and symmetry in both groups but no significant differences were observed between the two groups (respectively; p=0.183, p=0.578).

Conclusion: The scapular stabilization based exercise intervention was successful in increasing shoulder range, decreasing forward head and shoulder postures and Pectoralis minor flexibility.

No MeSH data available.


Related in: MedlinePlus