Subacromial Impingement Syndrome Research Articles

Effects of acupuncture on pain and function in patients with subacromial impingement syndrome: A randomized sham-controlled trial

BackgroundSubacromial impingement syndrome (SIS) is the most common cause of shoulder pain. Acupuncture is a traditional medicine that is effective on pain. This study aimed to evaluate the effect of acupuncture treatment on pain, function, range of motion (ROM) and quality of life compared to sham acupuncture in patients diagnosed with SIS. MethodsA randomized, prospective, double-blinded, sham-controlled trial was conducted. In acupuncture group 40 participants received acupuncture treatment plus exercise therapy while in control group 40 participants received sham acupuncture plus exercise therapy. Primary outcomes included pain-rest, activity and night pain. Secondary outcomes included function [Shoulder Pain and Disability Index (SPADI) and The Disabilities of the Arm, Shoulder and Hand Score (Quick DASH)], ROM, and quality of life [The Western Ontario Rotator Cuff Index (WORC)] in patients with SIS. ResultsBoth groups had significant improvements for pain-rest, activity night pain scores, SPADI, Quick DASH and WORC after treatment and at the first month follow-up. Significant improvements were recorded in the acupuncture group for all ROM after treatment and at the first month follow-up while in control group only in passive internal rotation. Acupuncture group had better improvements for Quick DASH, WORC and all ROM parameters after the treatment, as well as for all parameters except pain-night and passive flexion at the first month follow-up. ConclusionThis study suggest that acupuncture treatment is a safe, effective and non-invasive treatment option in patients with SIS. The study protocol is registered at clinicaltrials.gov (NCT05794633).

Radiographic findings in patients suspected of subacromial impingement syndrome: prevalence and reliability.

Aims were to (i) report prevalence and (ii) evaluate reliability of the radiographic findings in examinations of patients suspected of subacromial impingement syndrome (SIS), performed before a patient's first consultation at orthopaedic department. This cross-sectional study examined radiographs from 850 patients, age 18 to 63years, referred to orthopaedic clinic on suspicion of SIS. Prevalence (%) of radiographic findings were registered. Inter- and intrarater reliability was analysed using expected and observed agreement (%), kappa coefficients, Bland-Altman plots, or intraclass coefficients. A total of 850 patients with a mean age of 48.2years (SD = 8.8) were included. Prevalence of the radiographic findings was as follows: calcification 24.4%, Bigliani type III (hooked) acromion 15.8%, lateral/medial acromial spurs 11.1%/6.6%, acromioclavicular osteoarthritis 12.0%, and Bankart/Hill-Sachs lesions 7.1%. Inter- and intrarater Kappa values for most radiographic findings ranged between 0.40 and 0.89; highest values for the presence of calcification (0.85 and 0.89) and acromion type (0.63 and 0.66). The inter- and intrarater intraclass coefficients ranged between 0.41 and 0.83; highest values for acromial tilt (0.79 and 0.83) and calcification area (0.69 and 0.81). Calcification, Bigliani type III (hooked) acromion, and acromioclavicular osteoarthritis were prevalent findings among patients seen in orthopaedic departments on suspicion of SIS. Spurs and Bankart/Hill-Sachs lesions were less common. Optimal reliabilities were found for the presence of calcification, calcification area, and acromial tilt. Calcification qualities, acromion type, lateral spur, and acromioclavicular osteoarthritis showed suboptimal reliabilities. Newer architectural measures (acromion index and lateral acromial angle) performed well with respect to reliability.

Efficacy of Mulligan thoracic sustained natural apophyseal glides on sub-acromial pain in patients with sub-acromial impingement syndrome: a single-blinded randomized controlled trial

ABSTRACT Purpose To investigate the effects of Mulligan thoracic sustained natural apophyseal glides (SNAGS) techniques and traditional exercises on pain, shoulder function, size of sub-acromial space, and shoulder joint range in patients with sub-acromial impingement syndrome. Methods Seventy-four patients with sub-acromial impingement syndrome (25 to 40 years) joined this research and were allocated randomly into two equal groups; experimental group A (Mulligan SNAGS and exercise) and control group B (exercise only). All patients were assessed by visual analogue scale (VAS) for pain intensity, Shoulder Pain and Disability Index (SPADI) for shoulder function, plain x-ray for the size of sub-acromial space, and goniometer for shoulder range of motion (ROM). The measurements were performed at two intervals (baseline and after four weeks of intervention). Results After 4 weeks of intervention, there were statistically significant differences between groups, in favor of Mulligan SNAGS, on sub acromial space size, pain intensity, shoulder function, and shoulder joint range of motion (p < 0.05). In within-group analysis, there were also statistically significant differences between pre- and post-treatment in all measured variables (p < 0.05). Conclusion Mulligan thoracic spine (SNAGS) mobilization into extension and traditional exercises improve sub acromial space size, pain intensity, shoulder function, and shoulder joint range of motion in patients with sub acromial impingement syndrome. It is recommended to mobilize the thoracic spine by mulligan SNAGS in the treatment of sub-acromial impingement syndrome.

Can coracoacromial ligament degeneration be evaluated with preoperative MRI?

Subacromial impingement syndrome is one of the most common causes of painful shoulder in the middle-aged and elderly population. Coracoacromial ligament (CAL) degeneration is a well-known indicator for subacromial impingement. To examine the relationship between CAL thickness on preoperative magnetic resonance imaging (MRI), arthroscopic CAL degeneration and types of rotator cuff tears. Video records of patients who underwent arthroscopic shoulder surgery between 2015 and 2021 were retrospectively scanned through the hospital information record system. In total, 560 patients were included in this study. Video records of the surgery were used to evaluate the grade of coracoacromial ligament degeneration and the type of cuff tear. Preoperative MRI was used to measure CAL thickness, acromiohumeral distance, critical shoulder angle, acromial index, and acromion angulation. Significant differences were observed between grades of CAL degeneration in terms of CAL thickness (P < 0.001). As CAL degeneration increases, the mean of CAL thickness decreases. According to the results of post-hoc analysis, the mean CAL thickness of normal patients was significantly higher than those of patients with full-thickness tears (P = 0.024) and massive tears (P <0.001). Patients with articular-side, bursal-side, and full-thickness tears had significantly higher CAL thickness averages than patients with massive tears. This study showed that the CAL thickness decreases on MRI as arthroscopic CAL degeneration increases. High-grade CAL degeneration and therefore subacromial impingement syndrome can be predicted by looking at the CAL thickness in MRI, which is a non-invasive method.

Lifestyle factors and subacromial impingement syndrome of the shoulder: potential associations in finnish participants

BackgroundEmerging evidence has indicated the associations between subacromial impingement syndrome (SIS) of shoulder and lifestyle factors. However, whether unhealthy lifestyle factors causally increase SIS risk is not determined. This study aims to evaluate whether lifestyle factors are the risk factors of SIS.MethodsA two-sample Mendelian randomization (MR) study was designed to evaluate the effect of 11 lifestyle factors on SIS risk. Causality was determined using the inverse-variance weighted method to calculate the odds ratio (OR) and establish a 95% confidence interval (CI). Weighted median method, MR-Egger method and MR-PRESSO method were conducted as sensitivity analysis.ResultsFour lifestyle factors were identified causally associated with an increased risk of SIS using the IVW method: insomnia (OR: 1.66 95% CI 1.38, 2.00; P = 8.86 × 10− 8), short sleep duration (OR: 1.53 95% CI 1.14, 2.05: P = 0.0043), mobile phone usage (OR: 4.65, 95% CI 1.59, 13.64; P = 0.0051), and heavy manual or physical work (OR: 4.24, 95% CI 2.17, 8.26; P = 2.20 × 10− 5). Another causal but weak association was found between smoking initiation on SIS (OR: 1.17, 95% CI 1.01, 1.35; P = 3.50 × 10− 2). Alcohol, coffee consumption, physical activity, sedentary behavior, sleep duration and computer usage were not found to be causally associated with an increased risk of SIS. Sensitivity analyses indicated that the MR estimates were robust and no heterogeneity and pleiotropy were identified in these MR analyses.ConclusionSleep habits and shoulder usage were identified as causal factors for SIS. This evidence supports the development of strategies aimed at improving sleep behaviors and optimizing shoulder usage patterns as effective measures to prevent SIS.

Subacromial Impingement Syndrome. A Retrospective Analysis of Long-Term Outcomes of Surgical and Conservative Treatment

INTRODUCTION. Subacromial impingement syndrome (SAIS) is one of the most common reasons that makes patients seek treatment for shoulder pain.&#x0D; PURPOSE. To assess the effectiveness of surgical and conservative treatment of patients with subacromial impingement syndrome.&#x0D; MATERIALS AND METHODS. The clinical results of 48 patients with SAIS stage 1, 2 according to Neer, divided into 3 groups, were analyzed: 1) conservative group without rotator cuff tears (16 patients), 2) conservative group with partial rotator cuff tears (16 patients); 3) surgical group (16 patients). The patients of the conservative groups were treated according to the rehabilitation protocol including myofascial release techniques, physiotherapy, manual therapy, exercises. The patients of the surgical group underwent an arthroscopic subacromial decompression. The follow-up period was at least 24 months. The clinical condition of the patients was assessed using ASES, VAS scales and SANE questionnaire.&#x0D; RESULTS. The study did not reveal a statistically significant difference of the surgical and conservative treatment groups according to VAS and ASES. There was a statistically significant difference in the results of the SANE questionnaire (p = 0.008) with better results in the conservative groups. Longer rehabilitation was noted in patients of the surgical group.&#x0D; DISCUSSION. Ketola et al. compared clinical results of surgical group of patients who underwent the subacromial decompression and the conservative group who performed the exercises. There was no statistically significant difference found in VAS level results, subjective shoulder function assessment. Paavola et al. have not found statistically significant difference in VAS scale results between surgical group, group of diagnostic arthroscopy and conservative group of patients with rotator cuff tendinopathy.&#x0D; CONCLUSION. The conservative treatment of subacromial impingement syndrome with physiotherapy and manual therapy let achieve good and excellent results.

Comparison of the Post Treatment Outcomes of a Conservative Physiotherapy Protocol for Subacromial Impingement Syndrome in Terms of Acromion Morphology

Objective: The present study aimed to compare the results of a conservative physiotherapy (CP) protocol for subacromial impingement syndrome (SIS) in terms of the morphological types of acromion. Methods: Fifty patients participated in the present study, and they were divided into 3 groups according to the acromion morphology types. A 8-week CP (4-week treatment period at the clinic and, in addition, an exercise program at home for 4 weeks) was applied to all patients. The patients were evaluated in terms of pain (at rest and activity) by the Visual Analog Scale, range of motion (ROM), joint position sense (laser pointer), muscle strength (digital dinamometer), and functionality (the Shoulder Pain and Disability Index, SPADI) before and after the treatment. Result: In the pre- and post-treatment changes (delta), the shoulder flexion angle increased less in the type 3 group than in the type 1 and type 2 groups (p&lt;0.05). In the shoulder abduction angle, there was a similar increase in the type 3 group compared to the type 2 group, while there was less increase in the type 1 group (p&lt;0.05). It was determined that there was more deviation in the change value of shoulder abduction position sense in the type 3 group compared to the other groups (p&lt;0.05). There was no difference between the groups in the change values of pain, muscle strength, or the SPADI score (p &gt; 0.05). Conclusion: Type 3 acromion may have a handicap in improving shoulder flexion and abduction ROM and shoulder abduction position compared to other types.

Enchondroma of acromion: case report of an unusual tumor location

Enchondroma is a benign cartilaginous tumor and is rarely located on the shoulder girdle. The lesion that affects the subacromial area can cause rotator cuff impingement’s clinical signs. Our aim is to present this patient who has shoulder pain and was finally diagnosed with an acromial enchondroma. A 62-year-old female patient had an insidious left shoulder pain in the last 2 years. At the physical examination of the left shoulder, subacromial impingement syndrome’s sign was noticed. Plain radiographs didn’t have any typical features and magnetic resonance imaging (MRI) images were used for diagnosis. Well-circumscribed hypointense content on T1-weighted images was observed, and the lesion was seen as hyperintense on T2-weighted images. At the same time, subacromial effusion was noticed. Because of enchondroma’s small size, the patient was followed up with medical treatment and radiographical features. At one year follow-up, there was no change in the size of the lesion and no increased complaint about her left shoulder. Physicians should keep in mind that enchondroma may occur rarely in acromion and this condition may cause subacromial impingement. Therewithal, this diagnosis which is a rare reason for subacromial impingement syndrome should be considered in the differential diagnosis of shoulder pain.

Comparison of the Effectiveness of the Ultrasound- Guided Subacromial, Acromioclavicular with Subacromial Injection and Suprascapular Nerve Block in Patients with Shoulder Subacromial Impingement Syndrome: A Randomized Controlled, Single Blind, Clinical T

Comparison of the Effectiveness of the Ultrasound- Guided Subacromial, Acromioclavicular with Subacromial Injection and Suprascapular Nerve Block in Patients with Shoulder Subacromial Impingement Syndrome: A Randomized Controlled, Single Blind, Clinical T

Testing the integrity of sensorimotor processing with tendon vibration and transcranial magnetic stimulation in persons with subacromial impingement syndrome

Testing the integrity of sensorimotor processing with tendon vibration and transcranial magnetic stimulation in persons with subacromial impingement syndrome

Diacutaneous Fibrolysis: An Update on Research into Musculoskeletal and Neural Clinical Entities.

Diacutaneous Fibrolysis (DF) is an instrumentally assisted manual therapy technique defined as "a specific instrumental intervention for normalizing the musculoskeletal system function after a precise diagnosis and preserving the skin's integrity". The aim of this technique is soft tissue mobilization with the assistance of specially designed, hook-shaped steel instruments in different musculoskeletal structures, such as the myofascia, aponeurosis, tendons, ligaments and scar tissues. Due to discrepant results between previous reviews and the quite abundant new evidence provided by recently published randomized clinical trials, we propound this narrative review to provide an update on the scientific evidence related to the fundamentals and clinical efficacy of DF. Current evidence primarily supports the mechanical effect of DF on connective soft tissues. Diminished deep tendon reflex and rigidity have been registered after the implementation of DF in healthy subjects. Though there is still much to uncover, scientific evidence supports the use of the technique for the clinical treatment of subacromial impingement syndrome, chronic lateral epicondylalgia, chronic patellofemoral pain syndrome, mild to moderate carpal tunnel syndrome, hamstring shortening, temporomandibular disorders, tension-type headache and chronic low back pain. Additional data are essential for better recommendations in the clinical practice of DF.

The role of bone morphology of the greater tuberosity and lateral acromion on subacromial space during scaption: a three-dimensional dynamic simulation analysis

BackgroundThe bone morphology of the greater tuberosity and lateral acromion plays a central role in subacromial impingement syndrome. The critical shoulder angle (CSA) and greater tuberosity angle (GTA) are two-dimensional measurement parameters that have been validated to evaluate it radiologically. These markers are, however, static and don’t consider the dynamic effect of glenohumeral motion.ObjectivesThis study aimed to better understand the biomechanics in subacromial impingement with a dynamic simulation based on a validated 3D biomechanical model coupling joint kinematics and 3D reconstructed computed tomography.Study design & methodsSixty-one patients were included in this study: a case group of 44 patients with degenerative rotator cuff tears involving only the supraspinatus, and a control group of 17 without a rotator cuff tear. Patients with previous surgeries, traumatic cuff tears, and cuff tear arthropathy were excluded. CSA, GTA, and impingement-free range of motion (IF-ROM) of the glenohumeral joint in scaption were calculated. Correlation tests were used to determine the relationship between ROM and CSA, GTA, and combined CSA and GTA values.ResultsCSA and GTA were significantly higher in the rotator cuff tear group (p = 0.001 and < 0.001), while IF-ROM was significantly higher in the control group (p = 0.001). There was no overall correlation between CSA and GTA (R = 0.02, p = 0.8). Individual correlation between both angles with IF-ROM was negatively weak for CSA (R = -0.4, p < 0.001) and negatively moderate for GTA and IF-ROM (R = -0.5, p < 0.001). However, combining both angles resulted in a negatively high correlation with IF-ROM (R = -0.7, p < 0.001).ConclusionSubacromial space narrowing during scaption is highly correlated to the cumulative values of GTA and CSA. These findings suggest that the combined bony morphology of the lateral acromion and greater tuberosity plays an important role in subacromial impingement.Level of evidenceIII

Short-Term Effects of Centralization of the Glenohumeral Joint and Dynamic Humeral Centering on Shoulder Pain, Disability, and Grip Strength in Patients with Secondary Subacromial Impingement Syndrome.

Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain in adults and is caused by muscle imbalance around the shoulder joint, which is referred to as secondary SIS. Centralization of the glenohumeral joint (CGH), one of the intervention methods for this, targets strengthening the control ability of the rotator cuff. Dynamic humeral centering (DHC) targets the learning of selective contractile function of the pectoralis major and latissimus dorsi as depressors of the humeral head. This study aims to determine the short-term effects of CGH and DHC on pain, disability, and grip strength in patients with secondary SIS. Forty-eight patients with secondary SIS participated in the study and were randomly allocated into three groups (CGH group (n = 16), DHC group (n = 16), and simple exercise group (n = 16)) and received the intervention for 50 min. The Constant-Murley score was used to assess shoulder pain and disability (primary outcome), and a hand-held dynamometer was used to assess grip strength (secondary outcome). Measurements were performed before the intervention and one day after the intervention. The results showed that the Constant-Murley score improved in the CGH and DHC groups. In addition, pain and disability (range of motion scores) improved in both the CGH and DHC groups. Improvements in disability (shoulder strength) and grip strength were seen only in the CGH group. Both CGH and DHC can be used as methods for short-term pain release and disability recovery in secondary SIS. In particular, CGH appears to be more effective in the short-term improvement in shoulder strength and grip strength.

Investigation of the effect of subacromial corticosteroid injections on intraocular pressure

Background: Subacromial corticosteroid injection is one of the most commonly used procedures to treat subacromial impingement syndrome. Despite their significant efficacy, corticosteroids have several serious adverse effects, including increased intraocular pressure (IOP) and visual loss. The purpose of this study is to determine the effect of subacromial corticosteroid injections on IOP. Materials and Methods: 42 patients with impingement syndrome, who received subacromial corticosteroid injection, were included in the study. Patients received a single dose of betamethasone. IOP was monitored using a tonometer prior to injection, 24 hours after injection, and one week following injection. Results: The average age of the patients was 52.1±9.0, and 31 (74%) of them were female. Patients’ mean IOP values were 16.0±2.6 mmHg, 16.4±2.4 mmHg, and 16.1±2.31 mmHg before injection, one day after injection, and one week after injection, respectively. Repeated ANOVA tests revealed no statistically significant difference between the three measurements (P=0.386). Age, gender, history of diabetes, and history of hypertension didn’t have a significant effect on IOP change after corticosteroid injection. Those with a family history of glaucoma had a significantly greater increase in IOP on day 1 post-injection than those without (P=0.05). Conclusions: This is the first study to examine the effect of subacromial corticosteroid injections on IOP change. While a single subacromial steroid injection has no statistically significant effect on IOP change, care should be taken, particularly in susceptible individuals and those who need repeated injections.

Mediating the Connection: The Role of Pain in the Relationship between Shoulder Muscle Strength, Joint Position Sense, and Sub-Acromial Impingement Syndrome

Sub-acromial Impingement Syndrome (SIS) is a prevalent shoulder pathology characterized by pain, muscle weakness, and altered joint position sense (JPS). This prospective study aimed to comprehensively assess the relationship between shoulder muscle strength, JPS, and pain in individuals with SIS. A total of 100 participants, including 50 with SIS and 50 healthy controls, underwent shoulder muscle strength testing and JPS evaluation in various directions (flexion, abduction, medial rotation, and lateral rotation). Pain intensity was quantified using a visual analog scale. Correlation analyses were conducted to explore the associations between muscle strength, JPS, and pain, with Cohen’s d values indicating the effect size. Individuals with SIS exhibited significantly lower shoulder muscle strength and greater JPS errors compared to the healthy controls (p &lt; 0.001, Cohen’s d = 0.51 to 0.84). The results showed strong positive correlations between muscle strength and JPS in all assessed directions (p &lt; 0.001, with r values ranging from 0.35 to 0.62). Mediation analysis revealed that pain partially mediated the relationship between muscle strength and JPS in all directions (p &lt; 0.005). This study highlights the multifaceted nature of SIS, emphasizing the coexistence of muscle weakness, proprioceptive impairments, and pain. The findings underscore the importance of addressing these factors in the comprehensive rehabilitation of individuals with SIS to optimize functional outcomes and enhance their quality of life.

Effectiveness of Pulse Electromagnetic Field Therapy in Patients With Subacromial Impingement Syndrome: A Double-Blind Randomized Sham Controlled Study

ObjectivesTo evaluate the 3-month effects of pulsed electromagnetic field therapy (PEMF) in the treatment of subacromial impingement syndrome (SIS). DesignPlanned analysis of a randomized controlled trial with 4- and 12-week follow-ups. SettingPhysical medicine and rehabilitation clinic, treatment unit. ParticipantsOf the 250 individuals screened for eligibility, participants with a diagnosis of SIS (N=80) were randomized to intervention or control groups. InterventionThe first group received PEMF + exercise and the second group received sham PEMF + exercise 5 days a week for a total of 20 sessions. Main Outcome MeasuresVisual Analog Scale (VAS), Constant Murley Score (CMS), Shoulder Pain and Disability Index (SPADI), Short Form-36 (SF-36) Quality of Life Questionnaire, and shoulder muscle strength measurement with an isokinetic dynamometer. Evaluations were performed before treatment (T0), after treatment (T1), and 12th week (T2). ResultsEvaluation at T1 and T2 showed improvement in most parameters in both groups compared with baseline. In the comparison between the 2 groups at T1 and T2, more improvement was found in the PEMF group in most parameters. ConclusionsIn our study, PEMF was found to be superior to sham PEMF in terms of pain, ROM, functionality, and quality of life at the first and third months.

Comparison of the effects of manual therapy and scapular stabilization exercises on pain, functional status, and quality of life in subacromial impingement syndrome

Aims: This study aimed to determine the effects of manual therapy and scapular stabilization exercises combined with conventional physiotherapy on pain, functional status, and quality of life, and whether they are superior in individuals with subacromial impingement.&#x0D; Methods: 30 patients between the ages of 25-65 who were diagnosed with subacromial impingement syndrome were included in the study. Individuals were randomized 1:1 to "conventional physiotherapy+scapular stabilization" and "conventional physiotherapy+manual therapy" groups. Individuals' age, gender, medication use, and presence of chronic disease were recorded. The presence of pain was measured by the Visual Analogue Scale, shoulder range of motion was measured by a goniometer, quality of life was measured by Short Form-12 Quality of Life Survey, and functional status was evaluated with the Questionnaire Quick Disability of the Arm, Shoulder, and Hand Problems. The conventional physiotherapy program applied to both groups included electrotherapy, passive and active assisted range of motion exercises, and rotator cuff strengthening exercises. Both groups received a total of 12 sessions of physiotherapy, 3 days per week, for 4 weeks.&#x0D; Results: 19 females and 11 males, participated in the study. There were no statistically significant differences between the groups at baseline assessment for pain at rest, activity, and night (p=0,37; 0,39; 0,17, respectively), range of motion of shoulder flexion, abduction, internal rotation, and, external rotation (p=0,5; 0,1; 0,91; 0,9, respectively), Questionnaire Quick Disability of the Arm, Shoulder, and Hand Problems score (p: 0,09) and Short Form-12 Quality of Life Survey scores physical and mental component (p=0,23; 0,98, respectively). After treatment, both groups observed positive improvements in pain at rest, activity, and night (p=0,001), range of motion of shoulder flexion, abduction, internal rotation, and, external rotation (p=0,001), Questionnaire Quick Disability of the Arm, Shoulder, and Hand Problems score (p=0,001) and Short Form-12 Quality of Life Survey scores physical and mental component (Group1; p=0,001; 0,001, Group 2; p=0,001; 0,005, respectively). There was no statistically significant advantage among the treatment methods except for shoulder abduction and internal rotation range of motion parameters (p=0,04; 0,009, respectively).&#x0D; Conclusion: When applied with traditional physiotherapy, both treatment methods provided significant improvements in pain, functional condition, quality of life, and joint motion clarity compared to before treatment. However, the methods applied are not superior to each other. It is important to choose the appropriate technique for the patient in the treatment of subacromial impingement syndrome, and it is useful to prepare personalized, combined programs. It is envisaged that researching more effective exercise methods for patients with subacromial impingement syndrome in the future will increase the usefulness of the treatment.

Efficacy of Interferential Current Therapy in Patients Diagnosed with Subacromial Impingement Syndrome.

The objective of the study was to evaluate the effectiveness of interferential current treatment on a range of motion of joint and shoulder pain, functional status, and quality of life in patients with subacromial impingement syndrome and to compare interferential current with transcutaneous electrical nerve stimulation and sham interferential current. Patients complaining of shoulder discomfort participated in the present study. Diagnosis of subacromial impingement syndrome is based on anamnesis, clinical examinations, and shoulder magnetic resonance imaging. A total of 52 patients divided into 3 groups: Group 1 (17 patients, mean age 51.8 years) received interferential current, group 2 (18 patients, mean age 51.8 years) received transcutaneous electrical nerve stimulation, and group 3 (17 patients, mean age 49.1 years) received sham interferential current. Hot pack and exercise treatments were added to all groups. All groups were treated for 3 weeks, 5 times a week, for 15 sessions and 20 minutes for each session. Evaluations were made before treatment (T0), in the middle of treatment (T1; end of 8th session), and at the end of treatment (T2; end of 15th session) using active range of motion and visual analog scale for pain, the Arm, Shoulder, and Hand Problems Questionnaire for functional status, and Short Form-36 for quality of life. There were significant improvement effects on all of the range of motion, visual analog scale, and the Arm, Shoulder, and Hand Problems Questionnaire scores at T2 and on the scores in some subparameters of Short Form-36 in all groups (P < .05). However, there was no statistically significant difference at T2 between the groups (P > .05). Interferential current and transcutaneous electrical nerve stimulation exhibited equivalent results regarding range of motion, pain, function, and quality of life of patients with subacromial impingement syndrome, with no significant difference between interferential current and transcutaneous electrical nerve stimulation. Adding interferential current or transcutaneous electrical nerve stimulation treatments to hot pack +exercise therapy did not result in any extra benefits to the patients.

Glenohumeral Translations in Overhead Workers with Sub-Acromial Impingement Syndrome: A Review

Introduction: The third most common musculoskeletal condition is shoulder pain with a prevalence of up to 70%. The second most frequent shoulder condition is subacromial impingement syndrome. Impingement can be classified as either anterosuperior or posterosuperior. Faulty posture, altered scapular or glenohumeral kinematics, posterior capsular tightness, and acromial or coracoacromial arch pathology are all potential extrinsic mechanics that can lead to Subacromial impingement syndrome. The purpose of this review is to find the different variation in translation that takes place in the glenohumeral joint in Subacromial impingement syndrome in overhead workers. Methods: We performed a review of the various translations observed in the glenohumeral joint in subacromial impingement syndrome and discussed the evidence-based studies. For the review, an electronic search for relevant articles using PUBMED, Pedro, Research Gate, and Google Scholar databases up to Dec 2022 was done wherein MeSH search terms and free words were used. Articles underwent the selection process and were selected on the basis of inclusion criteria. Articles were selected based on the author's expertise, self-knowledge and reflective practice. Results: The current study included 11 articles that fulfilled the inclusion criteria suggesting that various humeral translations in overhead workers. The above-reviewed studies provided evidence that based on occupational demands abnormal variations occur. Conclusion: This review has provided an overview of the previous and recent literature on humeral head translation seen in sub-acromial impingement. This study concludes that superior translation is more common as compared to anterior-superior translation and posterior-superior translation.

Low-level laser therapy versus ultrasound therapy combined with home-based exercise in patients with subacromial impingement syndrome: A randomized-controlled trial.

The aim of this study was to evaluate the effects of low-level laser therapy (LLLT) and therapeutic ultrasound (US) combined with home-based exercise (HBE) versus HBE alone in patients with subacromial impingement syndrome (SAIS). Between March 2021 and July 2021, a total of 60 patients with SAIS (19 males, 41 females; mean age: 51.3±10.4 years; range, 30 to 70 years) were included. The patients were randomly allocated to an LLLT group (LG), an US therapy group (UG), and a control group (CG). The LLLT and US therapy programs were applied five times a week, for a total of 15 sessions. Home-based exercise programs and cold-pack therapy were administered to patients in each group. The patients were evaluated at baseline and one and three months of follow-up using the Visual Analog Scale (VAS) for pain during activity, at rest, and at night, and the Shoulder Pain and Disability Index (SPADI). All groups showed a significant improvement in the VAS and SPADI scores after the first month (p<0.05). The VAS activity pain score (p=0.008), SPADI pain score (p=0.003), SPADI disability score (p=0.012), and SPADI total score (p=0.003) significantly decreased in the LG compared to the CG at one month of follow-up. However, there were no significant differences in the outcome measures among the three groups at three months (p>0.05). The LLLT combined with HBE is more effective than HBE program alone for relieving activity pain and improving shoulder functions in the short term. However, LLLT and US therapy do not provide additional effects in terms of pain and disability at three months.