Eccentric training for shoulder abductors improves pain, function and isokinetic performance in subjects with shoulder impingement syndrome: a case series.
ABSTRACT Conservative treatments have been proposed for people with shoulder impingement syndrome (SIS), such as strengthening of the rotator cuff and scapular muscles and stretching of the soft tissues of the shoulder. However, there is a lack of studies analyzing the effectiveness of eccentric training in the treatment of SIS.
To evaluate the effects of eccentric training for shoulder abductors on pain, function, and isokinetic performance during concentric and eccentric abduction of the shoulder in subjects with SIS.
Twenty subjects (7 females, 34.2 SD 10.2 years, 1.7 SD 0.1 m, 78.0 SD 16.3 kg) with unilateral SIS completed the study protocol. Bilateral isokinetic eccentric training at 60º/s for shoulder abductors was performed for six consecutive weeks, twice a week, on alternate days. For each training day, three sets of 10 repetitions were performed with a 3-minute rest period between the sets for each side. The range of motion trained was 60° (ranging from 80° to 20°). The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to evaluate functional status and symptoms of the upper limbs. Peak torque, total work and acceleration time were measured during concentric and eccentric abduction of the arm at 60º/s and 180º/s using an isokinetic dynamometer.
DASH scores, peak torque, total work and acceleration time improved (p<0.05) after the period of intervention.
This study suggests that isokinetic eccentric training for shoulder abductors improves physical function of the upper limbs in subjects with SIS.
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ABSTRACT: PURPOSE: To investigate superior value of adding heavy load eccentric training to conservative treatment in patients with subacromial impingement. METHODS: Sixty-one patients with subacromial impingement were included and randomly allocated to the traditional rotator cuff training (TT) group (n = 30, mean age = 39.4 ± 13.1 years) or traditional rotator training combined with heavy load eccentric training (TT + ET) group (n = 31, mean age = 40.2 ± 12.9 years). Isometric strength was measured to abduction at 0°, 45° and 90° of scapular abduction and to internal and external rotation. The SPADI questionnaire was used to measure shoulder pain and function. Patients rated subjective perception of improvement. Outcome was assessed at baseline, at 6 and 12 weeks after start of the intervention. Both groups received 9 physiotherapy treatments over 12 weeks. At home, the TT group performed traditional rotator cuff strengthening exercises 1x/day. The TT + ET group performed the same exercises 1x/day and a heavy load eccentric exercise 2x/day. RESULTS: After treatment, isometric strength had significantly increased in all directions, and SPADI score had significantly decreased. The TT + ET group showed a 15 % higher gain in abduction strength at 90° of scapular abduction. Chi-square tests showed patients' self-rated perception of improvement was similar in both groups. CONCLUSION: Adding heavy load eccentric training resulted in a higher gain in isometric strength at 90° of scapular abduction, but was not superior for decreasing pain and improving shoulder function. This study showed that the combination of a limited amount of physiotherapy sessions combined with a daily home exercise programme is highly effective in patients with impingement. LEVEL OF EVIDENCE: II.Knee Surgery Sports Traumatology Arthroscopy 05/2012; · 2.68 Impact Factor
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ABSTRACT: Platelet Rich Plasma (PRP) is an emerging non-surgical intervention used for the treatment of tendon and ligament pathology. Despite the growing popularity of PRP in musculoskeletal medicine, there is a paucity of research that describes appropriate rehabilitation procedures following this intervention. This case report presents the rehabilitation strategy used following a PRP injection for a patient with a partially torn distal triceps tendon who previously failed physical therapy interventions. The patient returned to light weight training and coaching activity after completing 15 visits over a 3 month period. One month after discharge, the patient reported pain-free activities of daily living and a return to previously performed gym activities. PRP presents a viable treatment option for individuals who are recalcitrant to conservative interventions yet elect to avoid more invasive surgical measures. Despite the growing popularity of PRP, a paucity of evidence exists to guide physical therapists in the rehabilitation process of these patients. The rehabilitation strategies used in a patient who had a PRP injection for a partial triceps tendon tear are outlined. Although this case report highlights a successful rehabilitation outcome, future research regarding the concomitant effects of PRP injection and rehabilitation for tendon pathology are needed. 4-Case Report.International journal of sports physical therapy. 06/2013; 8(3):290-9.