Feedback improves the scapular-focused treatment effects in patients with shoulder impingement syndrome.

Abstract

This study aimed to evaluate the effects of scapular-focused treatment with (SFTF) and without (SFT) feedback on pain, function, and scapular kinematics in patients with Shoulder Impingement Syndrome (SIS). Seventy-five males and females with SIS were randomly assigned into SFTF (n = 25), SFT (n = 25) and control (n = 25) groups. The primary outcome was pain, assessed by Visual Analog Scale (VAS). The secondary outcomes were function and scapular kinematics, assessed by DASHQuestionnaire and a 3-D motion capture, respectively. All outcomes were measured at the baseline and after the 8-week interventions. A post hoc analysis performed to show significant differences between groups after the 8-week interventions. For pain, there were significant differences between SFTF vs. SFT (ES (95% CI) = -0.3(-0.4 to -0.1); P = 0.04), SFTF vs. control (ES (95% CI) = 1.3(0.7-1.9); P = 0.01). For DASH, also, there were significant differences between SFTF vs. SFT (ES (95% CI) = 1.8(1.1-2.4); P = 0.03), SFTF vs. control (ES (95% CI) = 4.4(3.3-5.4); P = 0.01), and SFT vs. control (ES (95% CI) = 2.6(1.8-3.4); P = 0.01). For scapular internal rotation (the sagittal or scapular planes), scapular upward rotation, and the scapular tilt, however, there were no differences between SFTF vs. SFT. Based on the study results, a rehabilitation program integrated with verbal feedbacks is effective to relieve pain, and improve function and scapular kinematics in patients with SIS. Adding feedback to an exercise therapy could clinically enhance outcomes in patients with SIS. Level II. This study was prospectively registered at UMIN-CTR website, and the unique trail number is UMIN000036399.