Scapular Kinematic and Impairment Features in Patients with Subacromial Impingement Syndrome: Outcome Prediction after Physical Therapy
Date Issued
2009
Date
2009
Author(s)
Hung, Cheng-Ju
Abstract
Subacromial impingement syndrome (SAIS) associated with pain and a loss of function has a high occurrence in the physically active population. Not all patients responded positively to physical therapy. The purposes of the study were 2-folds: (1) to identify the shoulder kinematic and impairment of the patients who are more likely to response to physical therapy. Specifically, this study used a prediction method modified from a clinical prediction rule to establish the method of outcome prediction after physical therapy in patients with SAIS. (2) To determine which changes of impairments pre and post treatment among patients are related to the successful outcome for SAIS. Thirty-three subjects presenting SAIS were studied to determine altered shoulder kinematics and impairments. Three measurements were collected: (1) three-dimensional scapular kinematics during performing functional tasks; (2) impairment measurements of range of motion and muscle force; and (3) self-reported measurements of pain, satisfaction, and function. All patients received 6 weeks (2 times per week) physical therapy. After intervention, all the measurements will be collected again. Improvement with treatment was determined using the Global Rating of Change Scale. Scapular kinematics and impairment measurements were first identified by t-test in predicting improvement and then combined into a multivariate prediction method. A prediction method with three variables (FLEX-SF score < 41, muscle power of serratus anterior < 27.4% body weight, degree of scapular internal rotation at 30° shoulder flexion during lowing arm phase in unloading condition < 0.7°) were identified. For determinating improvement, serratus anterior increased 6.16% body weight, and FLEX-SF improved 2 points were more valuable. It appears that scapular kinematics and impairment features may predict improvement in subjects with SAIS. Prospective validation of the proposed prediction method is needed to further investigated.
Subjects
Subacromial impingement syndrome
Physical therapy
Kinematic
Impairment
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