FUNCTIONAL ASSESSMENT ON THE PATIENTS WITH SHOULDER IMPINGEMENT

Abstract

ABSTRACT Introduction: The aims of our study were to identify the available functional examination tests (FET) and patient-reported outcome measures (PROM) instruments designed for subacromial impingement, to analyze and evaluate them and to develop a methodology for functional assessment of patients with shoulder impingement. Methods: A comprehensive search for all available FET and PROM and published review articles for subacromial impingement was undertaken on PubMed, PEDRO, Google Scholar, and Physiopedia up to June 2021. All full-text articles reporting evaluation, validation, surgical, and non-surgical treatment outcomes of these subacromial impingement FET and PROM were retrieved and analyzed by us, and a methodology for functional assessment of patients with subacromial impingement was developed. The methodology includes the following methods and tests: patient history, observation, palpation, examination of the movements, Visual Analogue Scale (VAS) for pain, examination of muscle balance (muscle length and tonus, isometric test, manual muscle testing), goniometry of the shoulder active range of motion (AROM), special tests (Neer test, Hawkins-Kennedy test), Shoulder Pain and Disability Index (SPADI). Results And Discussion: For a period of 1 year, we accessed 36 subjects diagnosed with primary shoulder impingement. They were randomly assigned to one of two physiotherapy groups: 1) supervised exercise only, and 2) supervised exercise with manual therapy techniques. Physiotherapy protocol involved twelve treatment sessions over a 6-weeks period. The analysis of the results confirms the positive effect of physiotherapy to decreases in pain, improved function, and increases in shoulder active range of motion. Conclusion: A methodology for functional examination of patients with subacromial impingement allows objective monitoring of the results of physiotherapy. Physiotherapy is effective in reducing pain and improving shoulder function in patients with subacromial impingement.