Progressive Resistance Exercises plus Manual Therapy Is Effective in Improving Isometric Strength in Overhead Athletes with Shoulder Impingement Syndrome: A Randomized Controlled Trial

Abstract

Reduction in isometric strength of the scapulohumeral muscles is a commonly seen impairment in overhead athletes afflicted with shoulder impingement syndrome (SIS). The purpose of this study was to compare the effects of two different treatment programs: progressive resistance exercises plus manual therapy (PRE plus MT) and motor control exercises (MCE), on isometric strength of upper trapezius (UT), middle trapezius (MTr), lower trapezius (LT), serratus anterior (SA), supraspinatus (Supr.), anterior deltoid (A.D), and latissimus dorsi (LD). 80 male university-level overhead athletes clinically diagnosed with SIS were randomly allocated into either of the two groups: PRE plus MT and MCE group. Athletes in the PRE plus MT group underwent graduated exercises with resistance elastic band, stretching exercises, and mobilization of the thoracic and shoulder joints. MCE group was submitted to motor control exercises in varied planar positions. Athletes in both groups underwent management 3 times a week for 8 weeks. Isometric strength of UT, MTr, LT, Supr, A.D, SA, and LD was measured at three-time points: baseline, 4th week, and 8th week. Relative to baseline, both interventions were found to be effective in increasing and optimizing the isometric strength of muscles ( p < 0.05 ) except for supraspinatus in the MCE group ( p > 0.05 ). However, athletes in PRE plus MT group presented a more pronounced increase in isometric strength than those in the MCE group. Between groups analysis found the largest isometric strength improvement in PRE plus MT group for A.D, followed by Supr. and UT muscles ( p < 0.05 ; effect size: 0.39 to 0.40). The study concluded that compared to MCE, PRE plus MT provides greater improvement in the isometric strength of scapulohumeral muscles.

Effectiveness of Combined Program of Manual Therapy and Exercise Vs Exercise Only in Patients With Rotator Cuff-related Shoulder Pain: A Systematic Review and Meta-analysis

“…4 More importantly, the majority of the included studies used more than 1 therapist for the delivery of the MT techniques, which could also have compromised the results. Finally, MT dosage was under-reported on many occasions 2,8,10,29,45,47 in terms of duration. As limited research exists on the optimal dosage of MT for shoulder pathology, research is necessary to establish the minimally effective dose of MT before examining its effectiveness.…”

“…14,15,18,22,28,54 Finally, 12 articles were found appropriate for a qualitative synthesis. 2,8,10,19,24,29,30,36,[45][46][47]55 After excluding 1 article 47 due to a lack of relevant data available in the full text and even after a request from the primary authors, the remaining 11 were found appropriate for quantitative synthesis. There was almost complete agreement between the 2 reviewers at the title/abstract screening stage (κ = 0.80) and at the full-text screening stage (κ = 0.82).…”

Virtual rehabilitation for patients with osteoporosis or other musculoskeletal disorders: a systematic review

“…Finally, FRT7 is calculated by the sum of FRT4, FRT5 and FRT6. Active knee Range of Motion (ROM): represents how much the knee can bend and straighten on its own (no external force for the active method) (Gianola et al 2020 ; Sharma et al 2021 ). Isometric strength: measures the ability of the patient to hold a sustained contraction against a resistance for a specific duration.…”

Analysis of the Therapeutic Efficacy of Arthroscopic Repair of the Subscapularis Tendon Combined with Coracoplasty

“…Shoulder impingement syndrome comprises three distinct types: subacromial impingement, subcoracoid impingement, and internal impingement [12,14,15]. However, clinical understanding of shoulder impingement often remains limited, and these various forms of impingement are occasionally amalgamated and addressed as subacromial impingement.…”