Faculty of Health, Universidad de las Américas, Santiago, Chile; Physical Therapy Department, Clinical Hospital San Borja Arriarán, Santiago, Chile.
Faculty of Health, Universidad de las Américas, Santiago, Chile; Faculty of Health, Universidad SEK, Santiago, Chile.
Musculoskelet Sci Pract. 2019 Dec;44:102052. doi: 10.1016/j.msksp.2019.102052. Epub 2019 Aug 25.
Adaptive shortening of the pectoralis minor is one of the biomechanical mechanisms associated with subacromial pain syndrome (SPS).
To compare the effects of an exercise program alone with an exercise program in combination with pectoralis minor stretching in participants with SPS.
Randomized controlled trial.
Eighty adult participants with SPS were randomly allocated to two groups. The control group (n = 40) received a 12-week specific exercise program and the intervention group (n = 40) received the same program plus stretching exercises of the pectoralis minor muscle. The primary outcome measure was shoulder function assessed by a Constant-Murley questionnaire, and the secondary outcomes were the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analog scale (VAS), and pectoralis minor resting length.
The present study shows no difference between the two interventions according to the Constant-Murley questionnaire (1.5 points; p = 0.58), VAS at rest (0.2 cm; p = 0.11), VAS at movement (0.5 cm; p = 0.08), and pectoralis minor resting length (0.3 cm; p = 0.06). The DASH questionnaire showed greater functional improvement in the control group (5.4 points; p = 0.02). Finally, only pectoralis minor length index showed difference statistical significant in favor of intervention group (0.3%; p = 0.04).
In the short-term, the addition of a program of stretching exercises of the pectoralis minor does not provide significant clinical benefit with respect to functional improvement or pain reduction in participants with SPS.
Brazilian registry of clinical trials UTN number U1111-1210-3555. Registered 5 March 2018.
胸小肌的适应性缩短是与肩峰下疼痛综合征（SPS）相关的生物力学机制之一。
比较单独进行运动方案与运动方案结合胸小肌伸展对 SPS 患者的影响。
随机对照试验。
80 名成年 SPS 患者被随机分配到两组。对照组（n=40）接受 12 周的特定运动方案，干预组（n=40）接受相同的方案外加胸小肌伸展运动。主要结局测量指标是采用 Constant-Murley 问卷评估的肩部功能，次要结局测量指标是手臂、肩部和手残疾问卷（DASH）、视觉模拟评分（VAS）和胸小肌静息长度。
根据 Constant-Murley 问卷，两种干预措施之间没有差异（1.5 分；p=0.58）、静息时 VAS（0.2cm；p=0.11）、运动时 VAS（0.5cm；p=0.08）和胸小肌静息长度（0.3cm；p=0.06）。DASH 问卷显示对照组的功能改善更大（5.4 分；p=0.02）。最后，只有胸小肌长度指数显示干预组具有统计学意义的差异（0.3%；p=0.04）。
在短期，与 SPS 患者的功能改善或疼痛减轻相比，增加胸小肌伸展运动方案并没有提供显著的临床获益。
巴西临床试验注册处 U1111-1210-3555 号。2018 年 3 月 5 日注册。
