A comparison of the effectiveness of standard shrug exercise and modified shrug exercise in patients with functional shoulder impingement syndrome

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Introduction and Aim: Functional shoulder impingement is a relative loss of subacromial space due to abnormal scapular position and motion. It is characterized by a drooping shoulder and reduced scapular upward rotation and has been implicated in the presence of shoulder impingement. The shrug exercise has been prescribed in shoulder rehabilitation programmes to facilitate upward rotation of scapula by strengthening the upper trapezius muscle. The objective of this study was to compare the effectiveness of standard shrug exercise versus modified shrug exercise (at 30 of glenohumeral abduction) in subjects with functional shoulder impingement syndrome. Materials and Methods: The study involved 30 subjects of 25-40 years of age diagnosed with functional shoulder impingement syndrome secondary to scapular dyskinesis. The subjects were randomly distributed into two groups; group one received the standard shrug exercise, and group two received the modified shrug exercise. The pre-test and post-test pain and function were measured using NPRS and SPADI scales. The exercise was performed with 20 repetitions and 10 second holds 3 times a day for three weeks. Results:The result revealed a significant improvement in pain and function in all subjects who received modified shrug exercise as measured by NPRS and SPADI. The group that received standard shrug exercise too showed improvement, but it was comparatively lesser than group two who received the modified shrug exercise. Conclusion: The study concluded that modified shrug exercise is more effective than standard shrug exercise in subjects with functional shoulder impingement syndrome. © 2018 Indian Association of Biomedical Scientists. All Rights Reserved.

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Objectives The aims of this scoping review were to (1) determine the frequency and types of behavior change techniques (BCTs) and education utilized in trials investigating exercise interventions for rotator cuff related shoulder pain (RCRSP); (2) subcategorize the BCTs and education found in the trials to summarize all behavior change approaches reported by trials; and (3) compare the frequency, types, and subcategories of BCTs and education utilized in the clinical guidelines for managing RCRSP between the trials. Methods Data sources included Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid EMBASE, CINAHL Plus, Google Scholar and PubMed, and were searched from inception to June 2020. Trials assessing exercise interventions for RCRSP were included. Three authors independently determined eligibility and extracted data. The frequency and types of BCTs and education in the trials and clinical practice guidelines were reported and compared descriptively. Two authors assessed the content of the BCTs to develop subcategories. Results Most trials reported including at least one type of BCT (89.2%), which was most commonly feedback and monitoring (78.5%). There were many different approaches to the BCTs and education; for example, feedback and monitoring was subcategorized into supervised exercise, exercise monitoring, and feedback through external aids, such as mirrors. Clinical guidelines recommend supervision, goal setting, activity modification, pain management recommendations, information about the condition, and exercise education. Conclusions Although over two-thirds of trials reported including a BCT alongside exercise interventions for RCRSP, the breadth of these interventions is limited (supervision is the only common one). Future trialists should consider using any type of BCT that may improve exercise adherence and outcomes. Impact The findings of this review have (1) identified gaps in the literature, and (2) contributed to the design of future exercise interventions for RCRSP.
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