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#017- Home-Based exercise for Subacromial Impingement Syndrome

Estimated reading time: 1 minute, 23 seconds.*

Supervised physical therapy and home-based exercise are equally effective in patients with subacromial impingement syndrome

This systematic review and meta-analysis aimed to determine the effectiveness of supervised PT over home-based exercise on subacromial impingement syndrome.

  • 7 studies in systematic review and 4 studies in meta-analysis.
  • 205 Participants received supervised PT and 166 participants received home-based program.

Supervised PT program included:

  • Strengthening: for rotator cuff and subscapular muscles (4 studies).
  • Stretching: for rotator cuff and subscapular muscles (3 studies), and capsular and pectoral stretching (1 study).
  • Manual therapy: cervicothoracic manipulation (1 study) and joint and soft tissue mobilization (1 study).
  • Virtual reality: Nintendo Wii games (boxing, bowling, and tennis).
  • Doses range: 3 sets of 10 repetitions/daily to as long as possible/day for 5 to 6 weeks.

Home-based exercise program:

  • 6 Studies used the same program as supervised PT.
  • 1 Study applied unspecific exercises for neck and shoulder without an external load, in addition to subacromial corticosteroid injection.
  • Doses:
    • 30 to 45 minutes/day, 2 days/week for 5 to 6 weeks. (3 Studies)
    • Once or twice a day for 12 weeks. (4 studies)

Results:

  • Shoulder Function:
    • No significant difference between shoulder function in supervised physiotherapy group and home exercise program.
    • As measured by Shoulder Pain and Disability Index (SPADI), Constant-Murley questionnaire or Shoulder Disability Questionnaire (SDQ).
  • Pain:
    • No significant difference in the level of pain in the supervised physiotherapy group compared with the home exercise group.
    • As measured by visual analog scale (VAS).
  • Active ROM:
    • No significant difference in the active flexion in the supervised physiotherapy group compared with the home exercise group.
    • Measured using a goniometer or inclinometer.

Learned from this study:

  • Supervised physiotherapy program and home-based exercise for subacromial impingement syndrome are equally effective.
  • Most programs included strengthening and stretching for rotator cuff and scapular muscles.

Note:

  • There are several limitations of this study
    • Inadequate sample size, unclear randomization, concealed allocation and lack of blinding.

Final Note

  • For therapists that work in busy settings or where you can not provide multiple sessions, having evidence for the effectiveness of home-based programs is really helpful.

Recommended reads:

References

*Calculation is based on the average reading speed that around 200 words per minute (wpm).

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