Faculty of Health and Social Sciences, Molde University College, Molde, NORWAY.
Rosenborg Clinic of Physiotherapy, Trondheim, NORWAY.
Med Sci Sports Exerc. 2021 Jan;53(1):1-9. doi: 10.1249/MSS.0000000000002436.
Subacromial pain syndrome (SAPS) defined as pain of nontraumatic origin localized around the acromion, is a debilitating, common, and often chronic condition. Among many proposed underlying causes of SAPS, hypoperfusion and hypoxic conditions in and around the tendons may be an intrinsic cause of SAPS.
This study aimed to determine if adding high-intensity aerobic interval training (HIIT) of the rotator cuff to usual care was feasible in SAPS and improved shoulder endurance more than usual care alone, as well as to examine the influence on shoulder pain and disability and the response of tendinous microcirculation after HIIT.
Twenty-one subjects with chronic SAPS were randomized to two groups: experimental group (EG; n = 13) receiving HIIT in addition to treatment as usual and control group (CG; n = 8) receiving treatment as usual. Before and after 8 wk of exercise therapy, endurance performance was assessed by an incremental abduction exercise of the arm to exhaustion (TTE). Pain and disability was assessed by the shoulder pain and disability index (SPADI). Contrast-enhanced ultrasound of the musculus supraspinatus and tendon was utilized to indicate tendon blood flow.
Endurance in the TTE test improved by an estimated 233 s more on average in EG than in CG (P = 0.001; 95% confidence interval, 102 to 363). The SPADI score was reduced 22 points more on average in EG (P = 0.017; 95% confidence interval, -40 to -5). The change from pretest to posttest was significant in EG for both TTE test and SPADI improvement (P < 0.001). EG also experienced less pain during exercise after the intervention compared with CG (P < 0.001). Contrast-enhanced ultrasound indicated an increase in tendinous blood flow in EG (P = 0.019).
HIIT rotator cuff exercise seems to be a feasible intervention in SAPS, increasing endurance performance more than usual care alone.
定义为非创伤性起源于肩峰周围疼痛的肩峰下疼痛综合征（SAPS），是一种使人虚弱的、常见的、且常常是慢性疾病。在 SAPS 的许多提出的潜在原因中，肌腱内和周围的灌注不足和缺氧可能是 SAPS 的内在原因。
本研究旨在确定在 SAPS 中，向常规护理中添加高强度间歇训练（HIIT）的肩袖是否可行，并且比单独常规护理更能提高肩部耐力，以及检查对肩痛和残疾的影响以及 HIIT 后肌腱微循环的反应。
21 名患有慢性 SAPS 的受试者被随机分为两组：实验组（EG；n = 13）接受 HIIT 加常规治疗，对照组（CG；n = 8）接受常规治疗。在 8 周的运动治疗前后，通过手臂递增外展运动至力竭来评估耐力表现（TTE）。使用肩痛和残疾指数（SPADI）评估疼痛和残疾。利用对比增强超声检查冈上肌和肌腱，以指示肌腱血流。
EG 比 CG 平均多增加了 233 秒的 TTE 测试耐力（P = 0.001；95%置信区间，102 到 363）。EG 平均减少了 22 分的 SPADI 评分（P = 0.017；95%置信区间，-40 到-5）。EG 在 TTE 测试和 SPADI 改善方面，从测试前到测试后的变化均具有统计学意义（P < 0.001）。干预后，EG 在运动时的疼痛也比 CG 少（P < 0.001）。对比增强超声显示 EG 的肌腱血流增加（P = 0.019）。
HIIT 肩袖运动似乎是 SAPS 的一种可行干预措施，比单独常规护理更能提高耐力表现。
