Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Sports Health. 2024 Jan-Feb;16(1):97-108. doi: 10.1177/19417381231155190. Epub 2023 Mar 5.
Although exercise interventions are recommended in the management of subacromial pain syndrome (SPS), there is a lack of data regarding the exercises focusing on the principal biomechanical deficiencies that cause symptoms.
Utilizing progressive scapula retraction exercises (SRE) and glenohumeral rotation exercises (GRE) in the scapula stabilization program may lead to more reduction in symptoms and greater acromiohumeral distance (AHD) values.
A double-blind, randomized controlled trial.
Level 2.
A total of 33 patients were assigned randomly to either SRE or SRE+GRE. Both groups received a 12-week supervised rehabilitation program, including manual therapy and exercises (stretching and progressive scapula stabilization exercises). In addition, the SRE+GRE group performed GRE exercises at gradual elevation angles. From 12 to 24 weeks, patients performed exercise programs less frequently (3 times per week). Disability (shoulder pain and disability index [SPADI]), AHD (at 5 active abduction angles), pain intensity (visual analogue scale [VAS]), and patient satisfaction were recorded at baseline, 12 weeks, and 24 weeks. A total of 16 healthy individuals were recruited as a control group to compare AHD values. Data were analyzed using mixed model analyses of variance.
A statistically significant group-by-time interaction was found for AHD values ( = 6.38; = 0.001), a significant group-by-time interaction for SPADI-disability ( = 5.148; = 0.01), SPADI-total ( = 4.172; = 0.03), and for pain during activity ( = 3.204; = 0.05). However, no significant group-by-time interaction for SPADI-pain (F = 0.533; = 0.48), for pain at rest (F < 0.001; = 0.99), and at night (F = 2.166; = 0.15). Yet, a significant time effect was observed.
Progressive SRE and GRE in the scapula stabilization program lessens symptoms and improves AHD values in patients with SPS. Moreover, this program could preserve outcomes and further increase AHD when applied less frequently.
Utilizing SRE and GRE in the scapula stabilization program at gradual shoulder abduction angles provides better rehabilitation outcomes.
尽管运动干预被推荐用于治疗肩峰下疼痛综合征（SPS），但针对导致症状的主要生物力学缺陷的练习缺乏数据。
在肩胛稳定计划中使用渐进式肩胛回缩练习（SRE）和肩胛盂旋转练习（GRE）可能会导致症状减轻更多，肩峰肱骨头间距（AHD）值更大。
双盲、随机对照试验。
2 级。
共有 33 名患者被随机分配到 SRE 或 SRE+GRE 组。两组均接受为期 12 周的监督康复计划，包括手法治疗和运动（伸展和渐进式肩胛稳定运动）。此外，SRE+GRE 组在逐渐增加的肩外展角度下进行 GRE 运动。从 12 周到 24 周，患者减少了运动频率（每周 3 次）。在基线、12 周和 24 周时记录了残疾（肩痛和残疾指数 [SPADI]）、AHD（在 5 个主动外展角度）、疼痛强度（视觉模拟评分 [VAS]）和患者满意度。共招募 16 名健康个体作为对照组以比较 AHD 值。使用混合模型方差分析进行数据分析。
AHD 值存在统计学上的组间时间交互作用（ = 6.38； = 0.001），SPADI 残疾（ = 5.148； = 0.01）、SPADI 总分（ = 4.172； = 0.03）和活动时疼痛（ = 3.204； = 0.05）存在显著的组间时间交互作用。然而，SPADI 疼痛（F = 0.533； = 0.48）、休息时疼痛（F < 0.001； = 0.99）和夜间疼痛（F = 2.166； = 0.15）无显著的组间时间交互作用。然而，观察到显著的时间效应。
肩胛稳定计划中的渐进式 SRE 和 GRE 可减轻 SPS 患者的症状并改善 AHD 值。此外，当应用频率较低时，该方案可以保持疗效并进一步增加 AHD。
在逐渐增加的肩部外展角度下，在肩胛稳定计划中使用 SRE 和 GRE 可提供更好的康复效果。
