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Scapular-focused treatment in patients with shoulder impingement syndrome: a randomized clinical trial

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Abstract

The purpose of this clinical trial is to compare the effectiveness of a scapular-focused treatment with a control therapy in patients with shoulder impingement syndrome. Therefore, a randomized clinical trial with a blinded assessor was used in 22 patients with shoulder impingement syndrome. The primary outcome measures included self-reported shoulder disability and pain. Next, patients were evaluated regarding scapular positioning and shoulder muscle strength. The scapular-focused treatment included stretching and scapular motor control training. The control therapy included stretching, muscle friction, and eccentric rotator cuff training. Main outcome measures were the shoulder disability questionnaire, diagnostic tests for shoulder impingement syndrome, clinical tests for scapular positioning, shoulder pain (visual analog scale; VAS), and muscle strength. A large clinically important treatment effect in favor of scapular motor control training was found in self-reported disability (Cohen’s d = 0.93, p = 0.025), and a moderate to large clinically important improvement in pain during the Neer test, Hawkins test, and empty can test (Cohen’s d 0.76, 1.04, and 0.92, respectively). In addition, the experimental group demonstrated a moderate (Cohen’s d = 0.67) improvement in self-experienced pain at rest (VAS), whereas the control group did not change. The effects were maintained at three months follow-up.

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Acknowledgments

This study was financially supported by MSD Europe bvba, Nijverheidsstraat 18, Londerzeel, Belgium, and by research grant (G842) supplied by the Department of Health Sciences, Artesis University College Antwerp, Antwerp, Belgium. The material used in this study was provided by MSD Europe bvba.

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Correspondence to F. Struyf.

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Trial registration: Clinical trials ISRCTN20736216

The study protocol was reviewed and approved by the Medical Ethics Committee of the UZ Brussel University Hospital, Brussels Free University (Vrije Universiteit Brussel), approved on 15 October 2008 (ref: BUN B14320084388).

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Struyf, F., Nijs, J., Mollekens, S. et al. Scapular-focused treatment in patients with shoulder impingement syndrome: a randomized clinical trial. Clin Rheumatol 32, 73–85 (2013). https://doi.org/10.1007/s10067-012-2093-2

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  • DOI: https://doi.org/10.1007/s10067-012-2093-2

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