A specific exercise strategy for patients with subacromial pain significantly reduced the need for surgery: one-year results of a randomised controlled study
(English)Manuscript (preprint) (Other academic)
Background: A specific exercise strategy focusing on eccentric exercises, for treating sbacromial pain has in a previous study been found effective at three-month followup.
The aim of the present study was to investigate if the positive short-term results were maintained after one year. A further aim was to examine if baseline clinical score, rotator cuff status and radiological findings influenced the choice of surgery.
Methods: 97 patients on the waiting-list for arthroscopic subacromial decompression were in the first study randomized to a three-month specific exercise strategy or unspecific exercises (controls). Patients were examined with radiology, ultrasound and assessed with clinical scores: primary Constant-Murley score. After three months of exercises the patients were asked if they still wanted surgery and this option was available until the one-year follow-up. All patients were re-assessed with clinical scores one year after inclusion or one year after surgical intervention and the number of patients that had chosen surgery in each group was compared. The baseline Constant-Murley score and the status of subacromial structures were analyzed in relation to patient's choice of surgery.
Results: The positive short-term effect (improved shoulder function and pain) of the specific exercises was maintained after one-year. Compared to the three-month followup all patients had improved significantly (p < 0.0001) in Constant-Murley score. The number of patients that had chosen surgery in the control exercise group (63%) was significantly larger (p < 0.0001) than in the specific exercise group (24%). Patients that had chosen surgery had a significantly lower baseline Constant-Murley score and significantly more often a full-thickness tear. Patients with partial-thickness tears did not differ from those with intact cuff tendons.
Conclusions: The positive short-term outcomes after specific exercises were maintained after one year and reduced the need of surgery significantly more than the unspecific control exercises. Patients with low baseline clinical score and/or a full-thickness tear significantly more often chose surgery.
Level of evidence: I, Randomized controlled trail according to Consort statement.
Subacromial pain patients, exercises, eccentric, rotator cuff tear
Orthopedics Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-82118OAI: oai:DiVA.org:liu-82118DiVA: diva2:557931
The original title of this article was: A specific exercise strategy reduces the need of surgery in subacromial pain patients: one-year results after a randomised controlled study. The title was changed before submitted to the journal.
On the day of the defence day the status of this article was Manuscript 2012-10-012012-10-012014-06-24Bibliographically approved