Abstract
ABSTRACTBackground: The understanding of the pathomechanics of shoulder impingement has evolved over the years. Likewise, assessment techniques and effective treatment strategies have also been developed. Physical therapists should keep up-to-date on the current evidence. Objective: This study explored the practices currently used by Indian physical therapists for the assessment and management of shoulder impingement syndrome (SIS). Method: Using an online questionnaire, therapists were asked to declare the causes, methods of assessment and their choices of physical therapy techniques for the management of SIS. The proportions of therapists using different techniques were analyzed descriptively, and comparisons across gender, experience level, and training were made. Data were analyzed to see if the choices of respondents compared with their responses for etiology. Results: A total of 211 responses were analyzed. Most respondents (>75%) believed that overuse and abnormal motion/posture are the most significant causes of SIS. However, fewer respondents reported assessing posture (60.2%) and dyskinesis, especially in women (24.2%). Ninety-four percent of the respondents reported using exercises, but exercise prescription was rather generic. Therapists additionally trained in the techniques of joint mobilization or taping declared using these techniques more frequently. The use of interferential therapy and ultrasound was reported by 89.5% and 98.4% of respondents, respectively Conclusion: Most therapists declared awareness of current recommended practices, but patient assessment, exercise prescription, and use of electrotherapy modalities were only partially based on current evidence. The study helps to identify gaps in current physical therapy approaches to SIS in India.
Highlights
Shoulder pain is a common clinical complaint in the outpatient departments of hospitals, ranking 3rd after low back pain and neck pain[1]
The understanding of the pathomechanics of Shoulder impingement syndrome (SIS) and evidence-based guidelines to manage the condition has evolved over the years[4]
A fictitious case of a patient diagnosed with SIS is presented below: Case of shoulder impingement presented in the questionnaire: A 40-year old man who works as a schoolteacher complains of pain in his right shoulder for a period of 6 weeks
Summary
Shoulder pain is a common clinical complaint in the outpatient departments of hospitals, ranking 3rd after low back pain and neck pain[1]. Shoulder impingement syndrome (SIS) is the most common cause of shoulder pain[2]. It commonly affects those exposed to overhead or repetitive activities[3]. The understanding of the pathomechanics of SIS and evidence-based guidelines to manage the condition has evolved over the years[4]. SIS is considered a non-specific term that includes multiple diagnoses (inflammation or partial tears of rotator cuff tendons; involvement of the long head of biceps; bursal inflammation)[4] and multiple subtypes (external or internal; subacromial or subcoracoid) and has a multifactorial etiology[3]. In addition to the intrinsic reasons, in recent years, efforts have been
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