Department of Physical Therapy and Nursing, Universidad de Alcalá de Henares, Spain.
Faculty of Physical Therapy, Nursing and Podiatry, Universidad de Sevilla, Spain.
J Hand Ther. 2018 Apr-Jun;31(2):227-237. doi: 10.1016/j.jht.2017.11.041. Epub 2018 Jan 10.
Randomized clinical trial.
Eccentric exercise (EE) was shown to be an effective treatment in tendinopathies. However, the evidence of its effectiveness in subacromial syndrome (SS) is scarce. Moreover, consensus has not been reached on whether best results for SS are obtained by means of EE with or without pain.
The purpose of this is to compare the effect on pain, active range of motion (AROM), and shoulder function of an exercise protocol performed with pain <40 mm Visual Analog Scale (VAS) and without pain, in patients with SS.
Twenty-two subjects (mean age: 59 years [Q1 = 48.50-Q3 = 70], 54.5% women) were randomized into a not-painful EE group (NPEE; G0: n = 11) and a painful EE group (PEE; G1: n = 11). The intervention lasted 4 weeks. Pain was recorded using VAS; AROM was measured using a goniometer; and shoulder function using the modified Constant-Murley Score (CMS) before and after intervention.
All dependent variables improved significantly in both groups (P < .05): NPEE VAS median: pretest = 55.0 posttest = 28.0; CMS median: pretest = 36.0 posttest = 65.0. PEE VAS median: pretest = 37.0 posttest = 12.0; CMS median: pretest = 35.0 posttest = 59.0. The comparison between groups showed no significant differences, with small effect size values (VAS = 0.09; CMS = 0.21; AROM = 0.12-0.43).
In contrast to the previous findings, our results suggest that PEE do not add benefit in SS patients compared to NPEE.
Our results suggest that both interventions are effective in terms of pain, function, and shoulder AROM. Furthermore, PEE does not provide greater benefits. Further studies are needed with long-term follow-up to reinforce these results.
随机临床试验。
离心运动（EE）已被证明是治疗腱病的有效方法。然而，其在肩峰下综合征（SS）中的有效性证据有限。此外，对于 SS 是通过有或无痛的 EE 获得最佳效果，尚未达成共识。
本研究旨在比较在 SS 患者中，疼痛<40mm 视觉模拟量表（VAS）和无痛时进行的运动方案对疼痛、主动活动范围（AROM）和肩部功能的影响。
22 名受试者（平均年龄：59 岁[Q1=48.50-Q3=70]，54.5%为女性）被随机分为无痛 EE 组（NPEE；G0：n=11）和疼痛 EE 组（PEE；G1：n=11）。干预持续 4 周。使用 VAS 记录疼痛；使用量角器测量 AROM；使用改良 Constant-Murley 评分（CMS）评估肩部功能，在干预前后进行评估。
两组所有依赖变量均显著改善（P<.05）：NPEE VAS 中位数：术前=55.0 术后=28.0；CMS 中位数：术前=36.0 术后=65.0。PEE VAS 中位数：术前=37.0 术后=12.0；CMS 中位数：术前=35.0 术后=59.0。组间比较无显著差异，效应量值较小（VAS=0.09；CMS=0.21；AROM=0.12-0.43）。
与之前的研究结果相反，我们的结果表明，与 NPEE 相比，PEE 并不能为 SS 患者带来额外的益处。
我们的结果表明，两种干预措施在疼痛、功能和肩部 AROM 方面均有效。此外，PEE 并不能提供更大的益处。需要进行长期随访的进一步研究来强化这些结果。
