Patients with Subacromial Pain Syndrome Present no Reduction of Shoulder Proprioception: A Matched Case‐Control Study

Abstract

Background Shoulder pain is common among patients with musculoskeletal pain and the prevalence of patients with subacromial pain syndrome (SAPS) is high. Despite the high prevalence, there is a lack of an extensive evaluation of the proprioception acuity in patients with SAPS. Knowledge of the proprioceptive deficit would assist clinicians in the proper treatment and may offer an alternative explanation for the mechanisms underlying SAPS, which are poorly understood. Objective To compare the proprioceptive function of the shoulder in patients with SAPS and matched controls. Study Design Matched case‐control study. Setting Physical Functional Rehabilitation Service of an outpatient clinic. Participants A total of 32 consecutive patients with SAPS who sought physical therapy for shoulder pain and 32 healthy participants (control group) matched for age, sex, and handedness. Interventions All participants completed a questionnaire containing sociodemographic information, pain intensity and characteristics, the Numerical Pain Rating Scale, and the Shoulder Pain and Disability Index. Main Outcome Measurements The proprioceptive assessment was performed through kinesthesia, passive joint position sense (PJPS), and the active joint position sense (AJPS). Results The groups showed no statistically significant differences in kinesthesia, PJPS, and AJPS for internal or external rotation. The proprioceptive acuity was not associated with pain intensity or functional disability in patients with SAPS. Conclusions Participants with SAPS did not present proprioceptive deficits in a pain‐free motion of medial and lateral rotation when compared to their matched controls. The proprioceptive deficit may not be involved with the mechanisms underlying SAPS and seems not to interfere with the clinical outcomes of patients with SAPS. Level of Evidence Level III.

The effect of conservative therapies on proprioception in subacromial pain syndrome: a narrative synthesis

“…The risk of bias in this study was low, and a reliability assessment showed that measurements were performed with good reliability during testing in 40 and moderate reliability during testing in 100 (Table 2) [16]. During both passive and active axial humerus rotation testing neither of the two studies found a difference in MM degree between patients with SAPS and controls [18,34]. Thus, Joint Position Sense in patients with SAPS may be affected during high scaption [16], but seems to be preserved during axial humerus rotation [18,34].…”

“…Two additional articles were retrieved from the reference lists of included studies. Thirteen full-text articles were excluded, resulting in 12 articles for the final analysis ( Figure 1) [16][17][18][27][28][29][30][31][32][33][34][35]. One study performed both a comparison of proprioception between patients with SAPS and controls and assessed the efficacy of an intervention in SAPS, and was therefore used for both study questions (Table 1) [32].…”

“…Three studies compared Joint Position Sense between a total of 73 patients with SAPS and 92 controls (Table 1) [16,18,34]. Joint Position Sense was tested using Joint Position Reproduction tasks (JPR) in scapular plane abduction (scaption) [16] and axial humerus rotation [18,34].…”

“…Three studies compared Joint Position Sense between a total of 73 patients with SAPS and 92 controls (Table 1) [16,18,34]. Joint Position Sense was tested using Joint Position Reproduction tasks (JPR) in scapular plane abduction (scaption) [16] and axial humerus rotation [18,34]. Active JPR testing in scaption showed that patients with SAPS have a higher Degree of Mismatch (MM degree ) compared to controls at 100 , indicating reduced Joint Position Sense, which was not present during testing in 40 scaption (Table 3) [16].…”

Efeito agudo do estímulo vibratório com barra flexível na ativação dos músculos escapulares em indivíduos com e sem a síndrome da dor subacromial

“…O SPA é classificado como uma submodalidade da propriocepção que tem como função interpretar a informação sobre a posição e orientação no espaço (Myers et al, 2006). A literatura científica sobre propriocepção de indivíduos com SDS permanece inconclusiva, Sahin et al (2017) mostraram que indivíduos com SDS apresentam propriocepção alterada quando comparados a controles saudáveis (Sahin et al, 2017), enquanto Gomes et al (2019) mostraram que indivíduos com SDS não apresentaram déficits proprioceptivos quando comparados aos controles pareados (Gomes et al, 2019). Nosso estudo foi o primeiro a avaliar o SPA ativo em indivíduos com SDS utilizando uma ponteira laser e nossos resultaram apontaram uma diferença entre grupos apenas após exercício com barra flexível.…”