Abstract
BackgroundExercise is frequently suggested as a treatment option for patients presenting with symptoms of subacromial impingement syndrome. Some would argue implementing a specific exercise strategy with special focus on correction of kinematic deficits would be superior to general exercise strategy. There is however a lack of evidence comparing such exercise strategies to determine which is the most effective in the treatment of subacromial impingement syndrome. The aim of this review is to evaluate whether implementing specific exercise strategies involving resistive exercises are more effective than a general exercise strategy for the treatment of patients with subacromial impingement syndrome.MethodsRandomized controlled trials were identified through an electronic search on PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science and PEDro. In addition, article reference lists and Clinicaltrials.gov were searched. Studies were considered eligible if they included interventions with resistive specific exercises as compared to general resistance exercise. Four reviewers assessed risk of bias and methodological quality guided by Cochrane recommendations. Results were synthesised qualitatively or quantitatively, where appropriate.ResultsSix randomized controlled trials were included with 231 participants who experienced symptoms of subacromial impingement syndrome. Four studies evaluated the effectiveness of specific scapular exercise strategy and two studies evaluated the effectiveness of specific proprioceptive strategy. Five studies were of moderate quality and one study was of low quality. No consistent statistical significant differences in outcomes between treatment groups were reported in the studies. Standardized mean difference (SMD) for pain was SMD −0.19 (95% CI −0.61, 0.22) and SMD 0.30 (95% CI −0.16, 0.76) for function.ConclusionsThere is insufficient evidence to support or refute the effectiveness of specific resistive exercise strategies in the rehabilitation of subacromial impingement syndrome. More high quality research is needed to accurately assess this. This review provides suggestions on how to improve the methodological design of future studies in this area.
Highlights
Exercise is frequently suggested as a treatment option for patients presenting with symptoms of subacromial impingement syndrome
Trials were excluded if they recruited participants with severe injuries including full thickness rotator cuff tears adhesive capsulitis, osteoarthritis, fractures/dislocations, neoplasm, systemic inflammatory and autoimmune disorders; infection, neurologic disorders or pain relating to complex neck/shoulder disorders
All six studies investigated relevant specific exercise strategies over a short term [53,54,55,56,57,58]; Four studies evaluated the effectiveness of specific scapular exercise strategy [53,54,55,56] and two evaluated the effectiveness of specific proprioceptive exercise strategy [55, 57]
Summary
Exercise is frequently suggested as a treatment option for patients presenting with symptoms of subacromial impingement syndrome. Biomechanical alterations refers to the superior translation of humeral head and altered scapulohumeral kinematics often caused by a weakness and imbalance of the rotator cuff musculature and/or tendons opposing superiorly directed shifts as well as postural dysfunction [5, 8,9,10,11,12,13]. This can present as external impingement with narrowing of the subacromial space or internal impingement within the glenohumeral joint space [6, 8, 13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
