Individualized Versus General Exercise Therapy in People With Subacromial Pain Syndrome: A Randomized Controlled Trial

Abstract

Objective

To evaluate the effect of individualized exercises based on movement fault (MF) control on pain intensity, and disability in subjects with chronic subacromial pain syndrome (SAPS).

Design

Randomized controlled trial.

Setting

Rehabilitation clinics.

Participants

Thirty-eight participants with chronic SAPS (mean [SD] age, 52.23 (8.47); 60 % women).

Interventions

The participants were randomly allocated to 1 of the intervention groups (individualized exercises based on MFs control test designed to target specific movement faults) or the control group (commonly prescribed general scapular stabilization exercises). Both groups received exercise sessions twice a week for 4 weeks.

Main Outcome Measures

The primary outcome measures were pain intensity at rest (PR) and during arm raising (PAR) using a visual analog scale. Disability was assessed as a key secondary outcome, including the disabilities of the arm, shoulder, and hand (DASH) questionnaire and the Shoulder Pain and Disability Index (SPADI).

Results

Following completion of all exercise sessions, PAR was significantly lower in the intervention group compared to the control group (mean, 9.17; 95% confidence interval; 0.31-18.03; P=.04), with a large effect size (0.68). The reduction of PAR remained significantly lower in the intervention group than in the control group after 4 months of follow-up (mean, 18.29; 95% confidence intervals [CI], 9.09-27.48; P<.00) with a large effect size (1.27). Disability significantly decreased at 2-month (mean, 14.58, P=.002 on SPADI index; mean, 10.26, P=.006 on DASH index) and 4-month (mean, 19.85, P<.001 on SPADI index; mean, 12.09, P=.001 on DASH index) follow-ups in the intervention group compared to the control group.

Conclusion

Individualized exercises based on MFs control of the shoulder region was accompanied by decreased PAR and disability in subjects with SAPS.