Subacromial Impingement Syndrome Research Articles

Comparison of Kinesiotaping, Exercise and Subacromial Injection Treatments on Functionality and Life Quality in Shoulder Impingement Syndrome: A Randomized Controlled Study.

Disturbance of scapulohumeral rhythm has been shown to play a major role in subacromial impingement syndrome. Exercise, taping and subacromial injection are first ray conservative treatment modalities. We aimed to correct scapulohumeral rhythm with kinesio taping and exercise program via focusing on especially periscapular muscles not on glenohumeral structures to achieve scapulothorasic stabilization. Seventy five patients were divided into three groups randomly with different treatment modalities which are only exercise group (Group 1), kinesiotaping + exercise group (Group 2), and injection + exercise group (Group 3). Western Ontario Rotator Cuff Index (WORCI), Quick Disability of arm, shoulder, hand (Q-DASH), Constant- Murley Scores (CMS) were evaluated for each patient at the beginning, 15th and 60th days and compared in time and technique manner. Scores were analyzed statistically with One-way ANOVA and Chi-square tests. All the three groups had better results in short and long term follow ups as compared to initial admission. But in the second group 15th and 60th day results were superior to other groups significantly (p < 0,001). Most of recent studies using kinesio taping were focused on mechanical correction of humerus which will be an impaired treatment to correct the main cause of impingement. Not only mechanical correction of periscapular muscles and also stabilization of scapulae will help to gain scapulohumeral rhythm.

Comparison of mobilization with supervised exercise for patients with subacromial impingement syndrome.

This study aims to investigate the effects of joint mobilization with supervised exercise in patients with subacromial impingement syndrome (SAIS). This prospective, randomized-controlled study included a total of 40 patients (18 males, 22 females; mean age 43.52 years; range, 27 to 67 years) with SAIS of more than six weeks between June 2014 and June 2015. The patients were randomly allocated into two groups: Group 1 (n=20) received joint mobilization and neuromuscular electrical stimulation and Group 2 (n=20) received a supervised exercise program and neuromuscular electrical stimulation. The outcome measures included the range of motion, pain intensity, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form-patient self-report section, Short Form-36, and Global Rating of Change Questionnaire. Pain was evaluated using the visual analog scale (VAS). In both groups, the mean VAS scores significantly decreased and the range of motion significantly increased after treatment (p<0.05). Both joint mobilization and supervised exercise combined with neuromuscular electrical stimulation led to a significant improvement in function in patients with SAIS (p<0.05), although it did not significantly differ between the groups (p>0.05). Patient satisfaction with treatment was similar in both groups (p=0.28). Based on our study results, mobilization and supervised exercise yield comparable outcomes in patients with SAIS.

Outcomes of ketorolac versus depomedrol infiltrations for subacromial impingement syndrome: a randomized controlled trial.

Local subacromial infiltration with steroids is a common method of treatment of subacromial impingement syndrome. However, the use of steroids has concerns like tendon rupture, articular cartilage changes and infections. Local NSAIDs infiltration has recently been tried in literature. This study compares the effect of subacromial injections of ketorolac with steroids. A randomized controlled study was planned with 35 patients in each group. Patients in group-1 were infiltrated with subacromial ketorolac (60mg with 2% lignocaine) and in group-2 with a steroid (methylprednisolone-40mg with 2% lignocaine). A similar rehabilitation protocol was followed, and clinical outcomes were analyzed using visual analog scale (VAS) for pain and shoulder pain and disability score (SPADI) and range of motion at one-month and three-months follow-up. Total data of 67 patients were analyzed, as three patients were lost to follow-up. In group 1, mean VAS improved from 7.9 [Formula: see text] 0.95 to 3.19 [Formula: see text] 0.81 (p < 0.001) and SPADI improved from 61.41 [Formula: see text] 11.86 to 28.91 [Formula: see text] 9.06 (p < 0.001) at three months, respectively. In group 2, mean VAS improved from 8.05 [Formula: see text] 0.94 to 2.9 [Formula: see text] 0.64 (p < 0.001) and SPADI improved from 63.45 [Formula: see text] 9.64 to 25.32 [Formula: see text] 6.87 (p < 0.001) at three months, respectively. However, there were no differences in functional outcomes between the groups (p = 0.21 for VAS, p = 0.16 for SPADI). Subacromial ketorolac infiltration has an equivalent outcome as that of steroid infiltration. Ketorolac could be considered as a reasonable alternative to steroids in cases where it is contraindicated.

The incidence of impingement syndrome in cases of cervical radiculopathy: An analysis of 220 cases.

We hypothesized that cervical radiculopathy (CR) has a role in subacromial impingement syndrome (SAIS) etiology, which cannot be directly connected to anatomical causes. We aimed to investigate the presence of cervical radiculopathy in patients with SAIS diagnosed clinically and radiologically. Patients who had a clinical and radiological SAIS diagnosis between 2014 and 2016 were included in the study. Patients with secondary causes that led to SAIS were excluded. Cervical MRI of all patients with SAIS was examined for cervical radiculopathy. A significant (p< 0.05) relationship was found between SIAS and the presence of root compression on the same side. 35% of the patients with SIAS had root compression on the same side. Cervical radiculopathy and shoulder impingement syndrome can be easily confused due to the similarity of the symptoms and the anatomical proximity of the lesions. Although both diseases can occur with different mechanisms, we believe that there is a cause and effect relationship between them.

КИНЕЗИОТЕЙПИРОВАНИЕ И ВОЗМОЖНОСТЬ ЕГО ПРИМЕНЕНИЯ ПРИ ТРАВМАТИЧЕСКИХ ПОВРЕЖДЕНИЯХ ЧЕЛЮСТНО-ЛИЦЕВОЙ ОБЛАСТИ

Subject. A literature review is devoted to the urgent problem of maxillofacial surgery and surgical dentistry ― improving the efficiency of rehabilitation of patients with fractures of the lower jaw using kinesiotape.&#x0D; The goal is to study the materials of publications devoted to kinesiotape during traumatic injuries of the maxillofacial region.&#x0D; Methodology. The mechanisms of action of a kinesiological teip applied in the form of applications on the skin are described in detail, which lead to the creation of favorable conditions for sanogenetic processes that are realized in normalizing microcirculation, reducing edema and the severity of pain. An increase in the number of publications on the use of this method in the prevention and treatment of injuries of the musculoskeletal system in athletes was noted. Moreover, at present, kinesioteiping is also used in clinical medicine, for example, in the practice of neurology and orthopedics. According to modern scientific research, the use of kinesiotape in patients with chronic back pain, subacromial impingement syndrome, acute whiplash injury of the cervical spine can significantly reduce the severity of pain.&#x0D; Results. Despite the rather widespread use of the method of kinesiotapeing in sports and clinical medicine, in the available literature there is a small number of works devoted to its use in maxillofacial surgery, in particular for fractures of the lower jaw. The use of the method of kinesiotherapy after surgery for osteosynthesis of fragments of the lower jaw has significantly reduced the level of inflammatory edema and the intensity of the pain syndrome.&#x0D; Conclusions. The presented literature review results indicate that kinesiotherapy is a promising, simple, non-traumatic method of rehabilitation after surgical treatment of lower jaw fractures, which does not have side effects and complications and significantly improves the quality of life of patients.&#x0D; However, scientific studies devoted to the analysis of the use of kinesiotherapy for traumatic injuries of the maxillofacial region are not enough for this period.

Where and what damage occurs at the acromial undersurface in patients with rotator cuff tears?

The gross pathology of the acromial undersurface in shoulders with rotator cuff tears with subacromial impingement is not completely understood. Many researchers have focused on damage to the anterior one-third area of the acromial undersurface, but few have studied the middle and posterior one-third areas. The purpose of this study was to clarify where and what damage occurs at the acromial undersurface in patients with rotator cuff tears. We performed arthroscopic shoulder (n = 182, all with rotator cuff tears; mean age, 64.9 ± 8.4 years) and cadaveric shoulder (n = 23, 14 intact cuffs and 9 rotator cuff tears; mean age, 74.8 years) evaluations to observe the extent and degree of damage to the acromial undersurface. We statistically analyzed the association between the severity of the damage to the acromial undersurface (assessed using the Copeland-Levy classification as A0, normal; A1, minor scuffing; A2, major damage; or A3, visualization of bare bone area) and rotator cuff tear size (assessed using the classification of DeOrio and Cofield as partial; small, <1 cm; medium, 1-3 cm; or large or massive, >3 cm). The anterior, middle, and posterior one-thirds of the acromial undersurface were somewhat damaged (class A1-A3) in 92.6%, 90.1%, and 78.6%of shoulders with rotator cuff tears, respectively, according to arthroscopic evaluation. Increasing cuff tear size was significantly associated with worsening degree of damage to the acromial undersurface (P < .001). In the 9 cadaveric shoulders with rotator cuff tears, class A1-A3 damage was identified in the anterior one-third area in 100%, in the middle one-third area in 88.9%, and in the posterior one-third area in 33.3%. In the 14 cadaveric shoulders with a normal rotator cuff, class A1-A3 damage was identified in the anterior one-third area in 35.7%, in the middle one-third area in 14.3%, and in the posterior one-third area in 0.71%. Damage to the acromial undersurface in patients with rotator cuff tears occurred at the middle, posterior, and anterior one-third areas, and the degree of damage was related to cuff tear size. Surgeons should evaluate the entire acromial undersurface to check for subacromial impingement damage at the middle and posterior one-third areas as well as the anterior one-third area of the acromial undersurface; this might aid in the treatment of patients with rotator cuff disease or subacromial impingement syndrome.

Increased levels of inflammatory markers in the subscapularis tendon and joint capsule in patients with subacromial impingement

PurposeTo analyze biopsy samples from the subscapularis tendon and from the joint capsule from male patients with subacromial impingement syndrome and compare them with samples from male patients with post-traumatic recurrent shoulder instability, to detect increased inflammatory activity that might be present inside the humeroscapular joint.MethodsTwenty male patients scheduled for surgery for either subacromial decompression or Bankart reconstruction were included. Four biopsies from each patient were obtained during surgery from the capsule and the subscapularis tendon. Each specimen was analyzed for TNF-α, IL-6, CD-3 and CD-72. Multiplex fluorescence immunohistochemistry was performed on histological samples from the capsule and tendon to demonstrate the level of inflammatory markers. Fluorescence microscope images were acquired using an automated scanning system. On each slide, the number of pixels was registered and used in the analyses.ResultsThe subacromial impingement syndrome group comprised eight patients, median age 53 (45–74) years, while the instability group 12, median age 27 (22–48) years (p < 0.00001). The amount of IL-6 and TNF-α was significantly higher in the subscapularis tendon of the patients with subacromial impingement syndrome compared with instability patients (p = 0.0015 and p = 0.0008 respectively). In the capsular samples, significantly higher amount of TNF-α and CD-72 was found in patients with subacromial impingement syndrome compared with instability patients (p < 0.0001 for both). On the other hand, the amount of CD-3 was significantly higher in the instability group (p = 0.0013).ConclusionsThis study provides evidence that an extended inflammatory process is present, not only in the subacromial bursa but also in the glenohumeral joint in patients with subacromial impingement syndrome.Level of evidenceLevel III.Clinical relevanceTo develop a treatment targeted towards intra-articular inflammatory cytokines appears appealing.

Ultrasound-guided versus blind subacromial corticosteroid and local anesthetic injection in the treatment of subacromial impingement syndrome: A randomized study of efficacy.

Objectives This study aims to compare the effects of ultrasound (US)-guided and blind subacromial corticosteroid and local anesthetic (LA) injection in the treatment of subacromial impingement syndrome (SIS) on shoulder pain, range of motion (ROM), and functionality.Patients and methods The prospective study was conducted between 01 February 2017 and 31 May 2017. A total of 29 patients with clinical findings and magnetic resonance imaging (MRI) consistent with SIS were randomized into two groups: 14 patients received US-guided subacromial corticosteroid and LA injection and 15 patients received a blind subacromial corticosteroid and LA injection. Patients were evaluated before and one month after treatment. One patient was lost to follow up. The primary outcome measure was a visual analog scale (VAS) for shoulder pain. Secondary outcomes were active shoulder ROM in flexion and abduction, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the modified Constant-Murley Score (CMS).Results Twenty eight patients (11 males, 17 females; mean age 39.5 in the US guided group and 42.5 in the blind group; range 20 to 64 years in both groups) completed the study. There was a significant improvement in VAS for shoulder pain, active ROM, DASH questionnaire score and modified CMS in both groups four weeks after treatment (p<0.05). There was no between-group difference in VAS, ROM or DASH questionnaire scores. Following treatment, the modified CMS in the US-guided injection group was higher than in the blind injection group (p=0.02). However, when the mean change in modified CMS in the US-guided injection group was compared to that of the blind injection group, the difference was insignificant (p=0.23).ConclusionBoth US-guided and blind subacromial steroid injection improve shoulder pain, ROM, and functionality in SIS; one treatment option was not found to be superior to the other. Therefore, blind injection can be performed in clinical settings where US is not available. Equally, blind injection can also be performed in patients who have a definite diagnosis of SIS based on clinical and MRI findings.

Subacromial Impingment Syndrome does not alter muscle onset activation patterns during shoulder cardinal movement at different speed and load

This study examines neuromuscular firing patterns in healthy and subjects diagnosed with SIS of the periscapular, prime-moving, and rotator cuff muscles during “clinical” cardinal plane physiological movements at different speeds and loads. EMG recordings were taken in 34 healthy and 34 subjects diagnosed with Subacromial Impingement Syndrome (SIS) of the prime movers, periscapular, and rotator cuff muscles during flexion, scaption, and abduction performed at fast, medium, and slow speeds with a loaded (3 kg) and unloaded arm. Differences in firing patterns between groups were analyzed by fitting mixed linear models with random intercepts per subject, and fixed factors for group, muscle, movement type, speed, and load. No difference in timing of activation was seen between the healthy and SIS. Onset timing of prime movers, periscapular, and rotator cuff muscles were prior to movement in all scenarios studied, with rotator cuff muscles firing last. Speed and load appear to independently vary muscle activation timing in a non-intuitive manner in both healthy and SIS. The lack of different firing neuromuscular patterns in subjects diagnosed with SIS and healthy subjects raises the need to consider individual assessment of motor patterns rather than generalized patterns.

Radial extracorporeal shock wave therapy for patients with subacromial impingement syndrome

Objective To analyze the short-term therapeutic efficacy of radial extracorporeal shock wave therapy for patients with subacromial impingement syndrome. Methods A total of 106 patients diagnosed as having subacromial impingement syndrome between October 2017 and April 2019 were randomized into a radial extracorporeal shock wave therapy (rESWT) group of 36, an exercise rehabilitation group of 35 and a conventional therapy group of 35. In addition to family exercise therapy, the rESWT group underwent 2000 to 2500 shots of extracorporeal shock wave therapy at 10 Hz and a pressure of 1.5-2.5 bar, once a week for four consecutive weeks. The exercise group was given range of motion exercises, joint control training and tendon movement training for 45 minutes, three times a week for four consecutive weeks. The conventional therapy group was treated with a laser apparatus and low-frequency electrotherapy, once a day, three times a week. Constant-Murle scores (CMSs) and the short form health survey (SF-36) were used to evaluate the clinical efficacy before and after 1 month of treatment. Results Before the treatment there were no significant differences among the 3 groups in any of the measurements. After one month of treatment the average CMS pain score and total score of the exercise rehabilitation group were significantly better than the conventional therapy group′s averages. Moreover, the average body pain score, daily life ability, range of motion, muscle strength and total score of the rESWT group were all significantly better than the exercise and conventional therapy groups′ averages. In the SF-36 the average physical function, bodily pain, general health, and mental health scores of the rESWT groups were also significantly better than the other 2 groups′ averages. Conclusions Radial extracorporeal shock wave therapy is superior to exercise therapy and conventional therapy for patients with subacromial impingement syndrome. It can restore shoulder joint function and improve the quality of life in one month. Key words: Radial extracorporeal shock wave therapy; Subacromial impingement syndrome; Constant-Murley scoring; Shock wave therapy

Low-Level Laser Therapy for Patients with Subacromial Impingement Syndrome: A Literature Review

Introduction: Painful entrapment of subacromial structures versus the choraco-acromial arch is defined as subacromial impingement syndrome (SAIS). Many studies have been done on the use of low-level laser in the treatment of musculoskeletal disorders. However, as the results of the studies are controversial, this study reviewed the results of studies on the effect of low-level laser on the pain and function of patients with subacromial impingement syndrome. Materials and Methods : PubMed, Scopus, Elsevier, Science Direct, ProQuest, and Medline databases were searched to retrieve clinical trials in English language that were published during the years 2000-2019. The keywords were as shoulder, subacromial impingement syndrome, and low-level laser. Results: Using the keywords, initially 200 articles were obtained, out of which, 7 clinical trials in English language that met the inclusion criteria were evaluated. Conclusion: Studies showed that low-level laser was an effective modality for reducing pain and improving the function in subjects with subacromial impingement syndrome.

The Effect of Scapular Proprioceptive Neuromuscular Facilitation Techniques on Pain and Functionality in Subacromial Impingement Syndrome

The Effect of Scapular Proprioceptive Neuromuscular Facilitation Techniques on Pain and Functionality in Subacromial Impingement Syndrome

Effects of Modified Posterior Shoulder Stretching Exercises on Shoulder Mobility, Pain, and Dysfunction in Patients With Subacromial Impingement Syndrome

Posterior shoulder stretching exercises (PSSEs) aim to reduce posterior shoulder tightness (PST). Position modification of traditional PSSEs has been suggested to minimize inadequate control of scapular and glenohumeral rotation, possibly leading to increased subacromial impingement. Modified PSSEs will have positive effects on shoulder mobility, pain, and dysfunction. Randomized controlled trial. Level 1. A total of 67 symptomatic patients with subacromial impingement syndrome (SIS) and shoulder internal rotation asymmetry were randomly assigned to 3 groups: modified cross-body stretch (MCS) (n = 22; treatment program + MCS), modified sleeper stretch (MSS) (n = 22; treatment program + MSS), and a control group (n = 23; treatment program consisting of only modalities, range of motion [ROM], and strength training but no PSSEs) for 4 weeks. Pain, PST, shoulder rotation ROM, and dysfunction were evaluated. Pain, PST, shoulder rotation ROM, function, and disability improved in all groups (P < 0.05). The MCS and MSS groups had better results compared with the control group with regard to pain with activity, internal rotation ROM, function, and disability (P < 0.05). There was no significant difference between the stretching groups (P > 0.05). All treatments improved pain, shoulder mobility, function, and disability in patients with SIS. However, modified PSSEs in addition to a treatment program was superior to the treatment program alone (without PSSEs) in improving pain with activity, internal rotation ROM, and dysfunction. Moreover, stretching provided clinically significant improvements. Modified PSSEs, in addition to a treatment program, are beneficial for patients with SIS. Both modified cross-body and sleeper stretches are safe and efficacious for improving shoulder mobility, pain, and dysfunction.

Between Two Rocks and in a Hard Place: Reflecting on the Biomechanical Basis of Shoulder Occupational Musculoskeletal Disorders.

The aim was to review the biomechanical origins of occupational shoulder damage, while considering the complexity of shoulder mechanics and musculoskeletal consequences of diverse task demands. Accessible measures of physical exposures are the primary focus of occupational shoulder assessments and analyses. This approach has led to guidelines and intervention strategies that are often inadequate for mitigating shoulder disorders amongst the complexity of modern workplace demands. Integration of complex shoulder mechanics into occupational assessments, analyses, and interventions is critical for reducing occupational shoulder injury risk. This narrative review describes shoulder biomechanics in the context of common injury mechanisms and consequent injuries, with a particular focus on subacromial impingement syndrome. Several modulators of shoulder injury risk are reviewed, including fatigue, overhead work, office ergonomics considerations, and pushing and pulling task configurations. Relationships between work requirements, muscular demands, fatigue, and biomechanical tissue loads exist. This review highlights that consideration of specific workplace factors should be integrated with our knowledge of the intricate arrangement and interpersonal variability of the shoulder complex to proactively evaluate occupational shoulder demands and exposures. A standard method for evaluating shoulder muscle exposures during workplace tasks does not exist. An integrated approach is critical for improved work design and prevention of shoulder tissue damage and accompanying disability. This review is particularly relevant for researchers and practitioners, providing guidance for work design and evaluation for shoulder injury prevention by understanding the importance of the unique and complex mechanics of the shoulder.

Effect of the acromial inferolateral tilt on subacromial impingement syndrome: a retrospective magnetic resonance imaging assessment.

ObjectiveTo evaluate the effect of acromial inferolateral tilt on subacromial impingement syndrome.Materials and MethodsThe acromial inferolateral tilt was retrospectively quantified by two researchers on 346 shoulder magnetic resonance images using the glenoacromial (between the inferior proximal acromial surface and the glenoidal face) and acromioclavicular (between the axis of the proximal acromion and distal clavicle) angles.ResultsThe glenoacromial angle was associated with subacromial impingement syndrome (p < 0.001) and complete supraspinatus tendon rupture (p < 0.001), and the acromioclavicular angle was associated with partial or complete supraspinatus tendon rupture (p = 0.003). The area under the receiver operating characteristic curve (AUC), best cut-off angle, and odds ratio (OR) of the glenoacromial angle for impingement syndrome were 0.579 (95% confidence interval [CI]: 0.508-0.649; p = 0.032), 72°, and 2.1 (95% CI: 1.136-4.053), respectively. For complete supraspinatus tendon rupture, the AUC, best cut-off angle, and OR of the glenoacromial angle were 0.731 (95% CI: 0.626-0.837; p = 0.001), 69°, and 8.496 (95% CI: 2.883-28.33), respectively. For partial or complete supraspinatus tendon rupture, the AUC, best cut-off angle and OR of the acromioclavicular angle were 0.617 (95% CI: 0.539-0.694; p = 0.002), 17°, and 3.288 (95% CI: 1.886-5.768), respectively. Interobserver agreement found for the glenoacromial and acromioclavicular angles were 0.737 (95% CI: 0.676-0.787; p < 0.001) and 0.507 (95% CI: 0.391-0.601; p = 0.001), respectively.ConclusionInferolateral acromial tilt may have some impact on subacromial impingement syndrome; however, the best quantification method identified (glenoacromial angle) showed a moderate interobserver agreement and a fair performance to assess the risk of complete supraspinatus tendon rupture.

The acromion-greater tuberosity impingement index: A new radiographic measurement and its association with rotator cuff pathology.

Several radiographic parameters describe humeral head coverage by the acromion. We describe a new radiographic measurement, the acromion-greater tuberosity impingement index (ATI), and its ability to predict rotator cuff pathology. The ATI was measured with magnetic resonance imaging (MRI) and X-ray analysis in 83 patients with rotator cuff pathology and 76 patients with acute rotator cuff tears. The lateral acromial angle (LAA), acromion type, the acromion index (AI) and the critical shoulder angle (CSA) were measured to assess their correlations with the ATI. Receiver operating characteristic (ROC) curves were used to predict degenerative rotator cuff pathology. The change in the ATI after acromion surgery was evaluated in both groups. According to the ROC curves, the ATI is a good predictor of degenerative rotator cuff pathology on both X-ray (cut-off, 0.865) and MRI (cut-off, 0.965). Patients with degenerative rotator cuff pathology had a significantly higher average ATI compared to the trauma group (p = 0.001 for X-ray and MRI). The degenerative group had a significantly lower LAA (p = 0.001) and a higher ratio of type III acromion (p = 0.035) than the trauma group. The ATI on X-ray was negatively related to the LAA and positively related to the AI, the CSA and acromion type (each p < 0.05). The ATI on MRI was negatively related to the LAA and positively related to the AI and acromion type (each p <0.05). More patients in the degenerative group than the trauma group needed acromioplasty or acromion decompression (p < 0.05). The ATI on MRI was significantly lower after acromion surgery compared to before surgery in both groups (p < 0.05). The ATI is a good predictor of degenerative supraspinatus tendon tears or subacromial impingement syndrome. The ATI on MRI is more accurate and can precisely guide acromion surgery.

Morphometry of Acromion Process of Scapula with Respect to Gender

Background: Of the wide spectrum of musculoskeletal disorders affecting the shoulder, subacromial impingement syndrome is considered to be quite common. The main objective of the present study is to evaluate the morphometry of acromion and to measure other parameters like acromiocoracoid distance (ACD) and acromioglenoid distance (AGD). Materials And Method: Study was conducted on 100 male and 100 female adult scapulae. Length and breadth of the acromion, ACD, and AGD were measured using vernier callipers. Measured parameters were tabulated and analysed for statistical significance. Results: Acromial length, acromial breadth, ACD and AGD varied significantly with sex. Positive correlation was observed between above parameters in male scapulae, whereas positive correlation was seen only between ACD & AGD among female scapulae. Conclusion: The studied parameters could be help during diagnoses and treatment of shoulder pathologies. They can also be used for forensic and anthropological purposes for determining gender, ethnicity

Comparison of isometric muscle strength between painful and non-painful shoulders in patients with symptoms of subacromial impingement

ABSTRACT BACKGROUND AND OBJECTIVES: The subacromial impingement syndrome is a dysfunction of the glenohumeral joint which can cause pain, functional disability, dependence, and low quality of life. The aim of this study was to compare the muscle strength between painful and non-painful shoulders and to verify the relationship between shoulder pain and disability and isometric muscle strength of the upper limb and kinesiophobia level in individuals with symptoms of subacromial impingement syndrome. METHODS: Twenty volunteers with symptoms of subacromial impingement syndrome participated in the study. The evaluation was carried out by means of an evaluation form, the Shoulder Pain and Disability Index questionnaire (SPADI - BRAZIL) to assess disability and shoulder pain and the TAMPA questionnaire to analyze the level of kinesiophobia. The evaluation of shoulder isometric muscle strength was performed using the Manual Hand-Held Dynamometer stabilized by a rigid band in the movements of flexion, extension, abduction and internal and external rotation of the shoulder. RESULTS: In the comparison of muscle strength between symptomatic and asymptomatic side, evidence of significant difference (p<0.05) was verified for all movements evaluated. There was a significant negative relationship between shoulder pain and disability index and isometric muscle strength of flexion and internal rotation, and a significant positive relationship with the level of kinesiophobia. CONCLUSION: Individuals with symptoms of subacromial impingement syndrome showed a significant reduction in muscle strength of the symptomatic shoulder. The shoulder pain and disability index is related to the isometric muscle strength of the shoulder and to the level of kinesiophobia.

Randomized control trial comparing results of platelet rich plasma with steroid injection in subacromial impingement syndrome

Randomized control trial comparing results of platelet rich plasma with steroid injection in subacromial impingement syndrome

Can the efficacy of subacromial corticosteroid injection be improved using a single- session mobilization treatment in subacromial impingement syndrome? A randomized single-blind controlled trial

Background/aimThe objective in this study is to assess the short-term effects of a single-session mobilization in addition to subacromial corticosteroid (SACS) injection in impingement syndrome.Materials and methodsThe study was designed as a prospective randomized controlled single-blind, parallel group clinical trial. Patients (totally 84) were divided randomly into two groups equally. Forty-two patients in Group 1 received mobilization and SACS injection, whereas 42 patients in Group 2 only received SACS injections. A single SACS injection was applied in all patients. Mobilization was administered as a single session right after SACS injection. Patients’ evaluations were performed measuring active range of motion (AROM), visual analogue scale (VAS) during activity and rest, and Disabilities of Arm, Shoulder, and Hand Score (DASH) prior to treatment and in the first and fourth weeks following the treatment.ResultsBoth groups showed significant improvement in terms of AROM, VAS, and DASH scores in each evaluation step (P < 0.05). Visual analogue scale activity in the first week was significantly better in Group 1 (P = 0.028). Also, flexion and abduction degrees showed significantly better outcomes in Group 1 (P = 0.007, P = 0.036). ConclusionAddition of single-session mobilization might provide rapid improvement in flexion and abduction as well as early pain relief following SACS injections.