Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

Effectiveness of standardized physiotherapy exercises for patients with difficulty returning to usual activities after decompression surgery for subacromial impingement syndrome: a randomized controlled trial
Christiansen DH, Frost P, Falla D, Haahr JP, Frich LH, Andrea LC, Svendsen SW
Physical Therapy 2016 Jun;96(6):787-796
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function. OBJECTIVE: To evaluate the effectiveness at 3 and 12 months of a standardized physiotherapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery. DESIGN: A multi-center randomized controlled trial. SETTING: Six public departments of orthopedic surgery, two departments of occupational medicine, and two physiotherapy training centers in Central Denmark Region. PATIENTS: 126 patients reporting difficulty returning to usual activities at the postoperative clinical follow up 8 to 12 weeks after subacromial decompression surgery. INTERVENTION: A standardized exercise program consisting of physiotherapist-supervised individual training sessions and home training. OUTCOME MEASURES: The primary outcome was the Oxford Shoulder Score. Secondary outcomes included the Constant Score and the Fear Avoidance Beliefs Questionnaire. RESULTS: At 3 and 12 months, follow up data was obtained for 92% and 83% of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months with an adjusted mean difference of 2.0 (95% confidence interval -0.5 to 4.6) and at 12 months with an adjusted mean difference of 5.8 (95% confidence interval 2.8 to 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcomes. LIMITATIONS: The nature of the exercise intervention did not allow blinding of patients and care providers. CONCLUSION: The standardized physiotherapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and function at 12 months when compared to usual care.

Full text (sometimes free) may be available at these link(s):      help