The aim of this prospective, randomized clinical study was to compare the effectiveness of two physical therapy treatment approaches for impingement syndrome, either by joint and soft tissue mobilization techniques or by a self-training program. Thirty patients (Group 1, n = 15; Group 2, n = 15) with the diagnosis of an outlet impingement syndrome of the shoulder were treated either by strengthening the depressors of the humeral head with a guided self-training program (Group 1, age 49.5 +/- 7.9 years), or by joint and soft tissue mobilization techniques (Group 2, age 48.1 +/- 7.5 years). Group 1 was instructed with the active range of motion (ROM), stretching and strengthening exercise program including rotator cuff muscles, rhomboids, levator scapulae and serratus anterior with an elastic band at home at least seven times a week for 10-15 min and Group 2 received a prescription for 12 sessions of joint and soft tissue mobilization techniques, ice application, stretching and strengthening exercise programs and patient education in clinic for three times per week. All patients were tested with visual analog scale (VAS) for pain level, goniometric measurement for ROM and algometry for the pain threshold. Function was measured with a functional assessment questionnaire. The VAS (10 cm) used to measure pain with functional activities and the functional assessment questionnaire (Neer) were also measured 3 months after the initiation of treatment. Subjects in both groups experienced significant decreases in pain and increases in shoulder function, but there was significantly more improvement in the manual therapy group compared to the exercise group. For example, pain in the manual therapy group was reduced from a pre-treatment mean (+/-SD) of 6.7 (+/-0.3) to a post-treatment mean of 2.0 (+/-2.0). In contrast, pain in the exercise group was reduced from a pre-treatment mean of 6.6 (+/-1.4) to a post-treatment mean of 3.0 (+/-1.8). ROM at flexion, abduction and external rotation in the manual therapy group improved significantly while ROM in the exercise group did not. There were statistically differences among the groups in function (P > 0.05). Group 2 showed significantly greater improvements in the Neer Questionnaire score and shoulder satisfaction score than Group 1. The patients treated with manual physical therapy applied by experienced physical therapists combined with supervised exercise in a brief clinical trial showed improvement of symptoms including increasing strength, decreasing pain and improving function earlier than with exercise program.

The purpose of this randomized, double-blind study was to determine the acute effects of kinesio taping on pain, strength, joint position sense and balance in patients with patellofemoral pain syndrome (PFPS). Twenty-two subjects with PFPS participated in the study. Subjects were separated into two groups; kinesio taping (KT) and placebo kinesiotaping (PKT). All subjects were assessed before and 45-min after the applications. Muscle strength, joint position sense, static and dynamic balance and pain intensity were used as the main outcome measures. Among all outcome parameters significant differences were found between strength of quadriceps muscle at 60 and 180 • /s, and static and dynamic balance scores before and 45-min after application of KT. There was also a significant difference between strength of quadriceps muscle at 60 • /s and static balance scores before and 45 minutes after application of the PKT. Therefore KT application does not seem to be an effective treatment method for both decreasing pain and improving joint position sense for patients with PFPS.

The accelerated protocol is recommended to physical therapists during rehabilitation after arthroscopic rotator cuff repair to prevent the negative effects of immobilization and to support rapid reintegration to daily living activities.

No abstract

SM may be a useful manual therapy technique to apply to participants with a painful limitation of the shoulder. SM increases ROM and decreases pain intensity.

Therapeutic study, Level II.

Supervised exercise, supervised and manual therapy, and home-based exercise are all effective and promising methods in the rehabilitation of the patients with subacromial impingement syndrome. The addition of an initial manual therapy may improve the results of the rehabilitation with exercise.

Although muscle strength and functional performance clearly increased from the 6th to the 12th mo after surgery, coordination characteristics of involved side remained low. This pattern demonstrated that motor-coordination progression was not affected by strength development. Patients continued to have significant motor-coordination deficits even 12 mo postsurgery. Therefore, the authors recommend that neuromuscular-coordination exercises be included in long-term rehabilitation programs to improve motor coordination.