The effect of adding eccentric exercises to conventional physical therapy for patients with rotator cuff tendinopathy

Abstract

To evaluate the effectiveness of adding an eccentric training of the rotator cuff to conventional physical therapy in patients with subacromial pain syndrome involving rotator cuff tendinopathy. Fifty-nine patients with rotator cuff tendinopathy, diagnosed by a physiatrist, were included and randomly allocated into an experimental group (EG) or a control group (CG). The experimental group ( n = 31, mean age = 57.4 + 13.4 years) received an eccentric training plus a conventional physical therapy, including modalities, scapular stabilization exercises and stretching, while the control group ( n = 28, mean age = 63.1 + 10.0 years) received a conventional physical therapy only. Patients in both groups received treatments twice a week for 3 months. Primary outcomes were shoulder pain (a 0–100 mm Visual Analog Scale; VAS) and function measured with the Disabilities of the Arm, Shoulder and Hand (DASH) score. Secondary outcome measures were isometric strength of abduction at 90° of scapular abduction (hand-held dynamometer) and shoulder range of motion (forward elevation, external rotation, and internal rotation). All measurements were taken at baseline and after treatment. After treatment, both groups showed a significant decrease in VAS scores (EG: −16.4 mm, P = 0.003 and CG: −21.9 mm, P < 0.001) and a significant decrease in DASH score (EG: −8.8 points, P = 0.01 and CG: −7.5 points, P = 0.002). Both groups also had a significant increase in isometric muscle strength (EG: 1.9 pounds, P < 0.001 and CG: 1.8 pounds, P = 0.002). No statistically significant differences were found between the groups for any of the evaluated outcome measures. It was shown that both groups had significantly increased isometric strength, decreased pain and better function after 3 months of treatment. Conventional physical therapy with or without eccentric training is effective in treating patients with rotator cuff tendinopathy.