Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey.
Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
Sports Health. 2024 May-Jun;16(3):315-326. doi: 10.1177/19417381231181127. Epub 2023 Jun 28.
In subacromial pain syndrome (SPS), it is unknown whether posterior shoulder stretching exercises (PSSE) with rapid eccentric contraction, a muscle energy technique, improve clinical and ultrasonographic outcomes more than no stretching or static PSSE.
PSSE with rapid eccentric contraction is superior to no stretching and static PSSE in improving clinical and ultrasonographic outcomes in SPS.
Randomized controlled trial.
Level 1.
Seventy patients with SPS and glenohumeral internal rotation deficit were randomized into the modified cross-body stretching with rapid eccentric contraction group (EMCBS; n = 24), static MCBS group (SMCBS; n = 23), or control group (CG; n = 23). In addition to 4-week physical therapy, EMCBS received PSSE with rapid eccentric contraction, SMCBS static PSSE, and CG no PSSE. The primary outcome was internal rotation range of motion (ROM). Secondary outcomes were posterior shoulder tightness, external rotation ROM (ERROM), pain, modified Constant-Murley score, short form of the disabilities of the arm, shoulder, and hand questionnaire (QuickDASH), rotator cuff strength, acromiohumeral distance (AHD), supraspinatus tendon thickness, and supraspinatus tendon occupation ratio (STOR).
Shoulder mobility, pain, function and disability, strength, AHD, and STOR improved in all groups ( < 0.05).
In patients with SPS, PSSE with rapid eccentric contraction and static PSSE were superior to no stretching in improving clinical and ultrasonographic outcomes. Stretching with rapid eccentric contraction was not superior to static stretching, but improved ERROM compared with no stretching.
In SPS, both PSSE with rapid eccentric contraction and static PSSE included in physical therapy program are beneficial to improve posterior shoulder mobility and other clinical and ultrasonographic outcomes. In the case of ERROM deficiency, rapid eccentric contraction might be preferred.
在肩峰下疼痛综合征（SPS）中，尚不清楚后肩拉伸运动（PSSE）加快速离心收缩、肌肉能量技术是否比不拉伸或静态 PSSE 更能改善临床和超声结果。
PSSE 加快速离心收缩比不拉伸和静态 PSSE 更能改善 SPS 的临床和超声结果。
随机对照试验。
1 级。
70 例 SPS 和肩内旋不足的患者被随机分为改良跨体拉伸加快速离心收缩组（EMCBS；n = 24）、静态 MCBS 组（SMCBS；n = 23）或对照组（CG；n = 23）。除了 4 周的物理治疗外，EMCBS 还接受 PSSE 加快速离心收缩、SMCBS 静态 PSSE 和 CG 不进行 PSSE。主要结局是内旋活动范围（ROM）。次要结局是后肩紧张、外旋 ROM（ERROM）、疼痛、改良 Constant-Murley 评分、手臂、肩部和手残疾问卷（QuickDASH）短表、肩袖力量、肩峰肱骨头距离（AHD）、冈上肌腱厚度和冈上肌腱占据比（STOR）。
所有组的肩部活动度、疼痛、功能和残疾、力量、AHD 和 STOR 均改善（<0.05）。
在 SPS 患者中，PSSE 加快速离心收缩和静态 PSSE 比不拉伸更能改善临床和超声结果。快速离心收缩拉伸并不优于静态拉伸，但与不拉伸相比，ERROM 得到改善。
在 SPS 中，包含在物理治疗方案中的 PSSE 加快速离心收缩和静态 PSSE 均有益于改善后肩活动度和其他临床和超声结果。在 ERROM 不足的情况下，可能更倾向于使用快速离心收缩。
