Original articleScapular kinematics and impairment features for classifying patients with subacromial impingement syndrome☆
Section snippets
Design and subjects
This was a repeated-measures design and a predictive validity/diagnostic test study, with outcome measurements being taken before and after a 6-week physical therapy treatment. No control group was incorporated into this study. This study recruited 58 patients with SAIS from the orthopedics clinic in National Taiwan University Hospital and also through general announcements in local Internet media. After screening of the patients with the tests (criteria), 33 subjects met the criteria for the
Results
Of the 33 subjects recruited in this study, 32 patients completed the 6-week treatment. Subjects reported compliance rates of over 80% (sessions of actual treatment/sessions of proposed treatment). The final data were based on 33 subjects. In the case of the dropout, the sequence of variables was regarded as constant. After treatment, 23 subjects (69.7%) were classified as showing improvement and 10 (30.3%) as showing non-improvement (Table 2). The mean improvement in FLEX-SF scores in the
Discussion
In this study, we were primarily interested in classifying patients for improving clinical decision-making. Similar to previous studies (McClure et al., 2004, Walther et al., 2004), we were able to show adequate effects of 6 weeks of treatment in some of our patients. Additionally, our results support the classification in patients with SAIS. Less internal rotation of the scapula (0.7°), inadequate serratus anterior muscle force (27.4% body weight), and functional disability (FLEX-SF score < 41)
Conclusion
This investigation supports the assertion that classifying patients for improved clinical decision-making is possible. Based on the prediction method we found a subject with SAIS who meets 3 criteria (FLEX-SF score < 41, muscle force of serratus anterior < 27.4% body weight, degree of scapular internal rotation at 30° shoulder elevation < 0.7 degree) at baseline has a probability of 100% of demonstrating improvement at 6-week follow-up. Self-reported functional status and muscle force of the serratus
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2020, Journal of Manipulative and Physiological TherapeuticsCitation Excerpt :Table 1 shows sample characterization. The following inclusion criteria were adopted for the symptomatic participants: age between 18 and 60 years and history of unilateral shoulder pain for at least 1 month, regardless of the pain level, in the proximal anterolateral region,26 or C5 or C6 dermatomes,27 as determined by 3 of the following positive tests: Neer,28 Hawkins-Kennedy,29 Jobe,30 painful arc,3 external rotation resistance,31 Gerber, and Speed.32 The tests used to diagnose SIS usually exhibit high specificity or sensitivity, and the combination of these clinical tests is recommended to identify patients with SIS.3
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2018, Physical Therapy in SportCitation Excerpt :The basic descriptive characteristics of the participants are presented in Table 1. Symptomatic athletes had to present impingement symptoms that were clinically diagnosed as a combination of three or more positive signs of the following: Neer (Neer, 1972), Hawkins-Kennedy (Hawkins & Kennedy, 1980), Jobe (Jobe & Moynes, 1982), painful arc (Hung, Jan, Lin, Wang, & Lin, 2010), and resisted shoulder ER test (Park, Yokota, Gill, El, & McFaland, 2005). A combination of shoulder tests may provide better diagnostic accuracy to confirm shoulder impingement (Michener, Walsworth, Doukas, & Murphy, 2009).
Progressive conscious control of scapular orientation with video feedback has improvement in muscle balance ratio in patients with scapular dyskinesis: a randomized controlled trial
2018, Journal of Shoulder and Elbow SurgeryCitation Excerpt :Participants were included if they (1) were aged 18 to 60 years old, (2) had subacromial impingement syndrome diagnosed by clinical examination, and (3) had obvious medial border prominence of the scapula at 90° of arm elevation during the visual examination. Subacromial impingement syndrome was confirmed by fitting at least 2 of the following criteria based on several previous studies8,11,18: (1) positive Neer test, (2) positive Hawkins-Kennedy test, (3) positive empty can test, (4) positive resisted external rotation test, and (5) tenderness of the rotator cuff tendons. We did not, however, choose painful arc as a criterion because participants needed to accomplish several arm elevation tasks during the experiment.
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This study was funded by the National Science Council, Taiwan (NSC 97-2314-B-002-006-MY3).