In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .
Is Extracorporeal Shockwave Therapy Combined With Isokinetic Exercise More Effective Than Extracorporeal Shockwave Therapy Alone for Subacromial Impingement Syndrome? A Randomized Clinical Trial.
UNLABELLED Study Design Single-blind r and omized trial . Background Extracorporeal shockwave therapy ( ESWT ) has been shown to produce good results in the treatment of subacromial impingement syndrome ( SAIS ) . The efficacy of a combined administration of ESWT and isokinetic exercise ( IE ) has not yet been studied . Objectives To evaluate the efficacy of focused ESWT combined with IE for the rotator cuff versus focused ESWT alone in the treatment of SAIS . The secondary objective was to assess the isokinetic torque recovery ( external rotation at 210 ° /s , 180 ° /s , and 120 ° /s ) . Methods Thirty participants with SAIS were r and omly assigned to a focused-ESWT group or focused ESWT-plus-IE group . Subjects of both groups received 3 treatment sessions of focused ESWT over a period of 10 days . Participants in the second group also received IE for 10 therapy sessions . Outcome measures were the Constant-Murley score ( CMS ) , the visual analog scale ( VAS ) , and isokinetic parameters ( peak torque and total work calculated from 5 repetitions ) measured with the isokinetic test . Subjects were assessed at baseline , 10 days after the last treatment session with focused ESWT , and after 2 months of follow-up . Results At 2 months posttreatment , participants in the focused ESWT-plus-IE group showed significantly less pain ( focused-ESWT VAS , 3.4 ± 0.8 versus focused ESWT-plus-IE VAS , 1.5 ± 0.5 ; P<.001 ) and greater improvement in functionality ( focused-ESWT CMS , 75.9 ± 6.7 versus focused ESWT-plus-IE CMS , 92.1 ± 6.3 ; P<.001 ) and muscle endurance than the subjects in the focused-ESWT group . Conclusion In subjects with SAIS , combined administration of focused ESWT and IE for the rotator cuff result ed in greater reduction of pain , as well as superior functional recovery and muscle endurance in the short to medium term , compared with ESWT alone . Level of evidence Therapy , 2b . TRIAL REGISTRATION unregistered 2011 trial . J Orthop Sports Phys Ther 2016;46(9):714 - 725 . Epub 5 Aug 2016 . doi:10.2519/jospt.2016.4629
In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .