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 .
Neurocognitive therapeutic exercise improves pain and function in patients with shoulder impingement syndrome: a single-blind randomized controlled clinical trial.
BACKGROUND Traditional rehabilitation improves pain and function in patients with shoulder impingement syndrome .  Neurocognitive rehabilitation has shown to be highly effective after surgical reconstruction of the anterior cruciate ligament . However , its effects in patients with shoulder impingement syndrome have not yet been established . AIM The aim of the study was to compare the effects of neurocognitive therapeutic exercise , based on proprioception and neuromuscular control , on pain and function in comparison to traditional therapeutic exercise in patients with shoulder impingement syndrome . DESIGN Single-blind r and omized , non-inferiority clinical trial . SETTING Outpatient clinic of Geriatrics and Physiatrics , University Hospital . POPULATION Forty-eight patients with shoulder impingement syndrome ( Neer stage I ) and pain lasting for at least three months . METHODS Participants were r and omly allocated ( 1:1 ) to either neurocognitive therapeutic exercise or traditional therapeutic exercise . Both treatments were provided one-hour session , three times a week for five weeks . The primary outcome measure was the short form of the Disability of the Arm , Shoulder and H and Question naire ( Quick-DASH question naire ) for the assessment of physical ability and symptoms of the upper extremity . SECONDARY OUTCOME MEASURES Constant-Murley shoulder outcome score for the determination of range of motion , pain and strength ; American Shoulder and Elbow Surgeons Society st and ardized shoulder assessment form for the evaluation of physical ability in daily-living tasks ; a visual analogue scale for pain assessment at rest and during movements ; Likert score for the estimation of participant satisfaction . ENDPOINTS before treatment , end of treatment , 12 and 24 weeks after the completion of each intervention for all outcome measures , except for the Likert score that was evaluated only at the end of treatment . FOLLOW-UP 24 weeks . RESULTS At the end of treatment and at follow-up , both treatment groups experienced improvements in all outcomes measures relative to baseline values , except for the visual analogue scale at rest that was unaffected by traditional therapeutic exercise . For all outcome measures , changes over time were greater in the neurocognitive therapeutic exercise group relative to the traditional therapeutic exercise group . The level of satisfaction with treatment was higher for participants in the neurocognitive therapeutic exercise group . CONCLUSION Neurocognitive rehabilitation is effective in reducing pain and improving function in patients with shoulder impingement syndrome , with benefits maintained for at least 24 weeks . CLINICAL REHABILITATION IMPACT skills and function of the shoulder can greatly benefit from neurocognitive rehabilitation
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 .