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 (IRCT20221126056621N1) SETTING: Rehabilitation clinics PARTICIPANTS: Thirty-eight participants with chronic SAPS (aged 52.23(8.47), 60 %woman).

Interventions: The participants were randomly allocated to one 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 four 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 [CI]: 9.17 [0.31 to 18.03], p=0.04), with a large effect size [0.68]. The reduction of PAR remained significantly lower in the intervention group than in the control group after four months of follow-up (mean [CI]: 18.29 [9.09 to 27.48], p=0.00) with a large effect size [1.27]. Disability significantly decreased at two month (mean=14.58, p=0.002 on SPADI index; mean=10.26, p=0.006 on DASH index) and four month (mean=19.85, p=0.00 on SPADI index; mean=12.09, p=0.001 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.