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 .
Home exercises and supervised exercises are similarly effective for people with subacromial impingement: a randomised trial.
QUESTION Are there different effects of home exercises and supervised exercises on pain and disability for people with subacromial impingement ? DESIGN R and omised trial with two treatment arms , concealed allocation , blinded assessment of some outcomes , and intention-to-treat analysis . PARTICIPANTS Forty-six patients with subacromial impingement were recruited from an interdisciplinary outpatient clinic of physical medicine and rehabilitation at a university hospital in Norway . INTERVENTION The home exercise group had one supervised exercise treatment followed by exercises at home for 6 weeks . The supervised exercise group had up to 10 supervised exercise treatments in addition to home exercises for 6 weeks . OUTCOME MEASURES The primary outcome was the Shoulder Pain and Disability Index ( SPADI ) . Secondary outcome variables were : average pain during the past week , the Fear Avoidance Beliefs Question naire , participant satisfaction with treatment , active range of motion , work status and clinical shoulder tests . Pain was assessed weekly and all outcomes were assessed at 6 weeks . Participants were free to seek ongoing treatment of their choice until 26 weeks , when the SPADI was assessed again . RESULTS While both groups improved considerably , the groups did not differ significantly on the SPADI after the intervention at 6 weeks ( 0 points , 95 % CI -14 to 14 ) or when followed up at 26 weeks ( -2 points , 95 % CI -21 to 17 ) . There were no between-group differences for pain at any time . The remaining outcomes also did not differ significantly , except for the clinical tests of shoulder impingement . In the supervised exercise group , 11 out of 23 participants had two or more positive tests , compared to 18 out of 21 in the home exercise group . CONCLUSION Supervision of more than the first session of a 6-week exercise regimen did not cause significant differences in pain and disability in people with subacromial impingement . TRIAL REGISTRATION NCT01257113
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 .