Effectiveness of Pilates Exercise in Patients With Subacromial Impingement Syndrome

Cairo University34 enrolled

Overview

Subacromial Impingement Syndrome(SIS) is considered as one of the most common causes of shoulder pain, can be the source of considerable pain, disability and leads to limitations in activities of daily living. This study aimed to investigate the effectiveness of the Pilates versus conventional treatment on shoulder pain, function, ROM and muscle strength in patients with SIS.

Shoulder pain is the third most common chronic pain among musculoskeletal disorders, following low back pain and knee pain; it is usually characterized as non-traumatic complaints that arise from arm, neck and shoulder regions. Approximately 50% of those experiencing shoulder pain have symptoms that indicate subacromial impingement syndrome (SIS) diagnosis; the prognosis varies widely; from pain to limited range of motion affecting their daily life activities: with about 40% of individuals suffer from pain one year later after their initial consulting with their primary care clinician. The SIS is a painful condition that characterized by narrowing of the subacromial space that causes inflammation and degeneration of rotator cuff structures, resulting in pain during arm elevating. Previous research identified many causes for the impingement such as poor posture, overuse or repetitive trauma, age-related changes, fatigue of the scapular and glenohumeral muscles, biomechanical alterations, neuromuscular adaptations, rotator cuff and deltoid muscle imbalances. It leads to pain, disability, limited range of motion (ROM), loss of muscle strength, poor quality of life and sleep disturbances. There are many treatment approaches adopted for SIS such as conservative, pharmaceutical and surgical approach in severe cases. Regarding the conservative it is considered the main treatment of SIS it often includes therapeutic exercises such as scapular stabilization exercises, rotator cuff strengthening exercises, stretching exercises and Pilates exercise that are effective in restoring shoulder function. Pilates exercise was developed by Joseph Pilates as a comprehensive exercise, emphasizes the connection between mind and body control, making it a valuable tool in rehabilitation for enhancing core muscle strength, endurance, flexibility, posture, ROM, overall health, and quality of life are prevalent for both healthy individuals and rehabilitation purposes for SIS. Pilates has been shown to effectively reduce shoulder pain, improve ROM, enhance posture, and support functional recovery in individuals with chronic shoulder pain, as highlighted in studies emphasizing its role in core stability and movement control even though it has a favorable impacts, the evidence to demonstrate its effect is limited.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Subacromial Impingement Syndrome Pilates Exercise Shoulder Bursitis

Interventions

ConventionalBEHAVIORAL

patients received conventional physical therapy exercise program that include (rotator cuff strength exercise, scapular stability exercise and posterior capsule stretch exercise) for 18 sessions for 6 weeks

Pilates exerciseBEHAVIORAL

patients who received the Pilates exercise in form of (shoulder drop, chest opener, book opening, scarecrow, dart, quadruped exercise, spine twist exercise).

Eligibility

Sex: ALLMin age: 35 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Male and female patients aged between 35-65 years old * Presence of shoulder pain for at least three months * Painful arc of movement during flexion or abduction or both * The patient will be diagnosed with SIS if the tests of the Neer, Empty Can, and Hawkins will be positive during the physical examination. Exclusion Criteria: 1. History of any surgical procedure to the affected upper extremity (Heron et al., 2017 and). 2. History of trauma, fracture, instability and shoulder dislocation to the shoulder in less than 12 weeks previously (EDA et al., 2016). 3. History of presence of cervical symptoms (neck pain, numbness or tingling in the upper extremity) (Heron et al., 2017). 4. History of corticosteroid injection in the shoulder region in the last 6 months (Turgut et al., 2017). 5. None- cooperative participants or cognitive impairment (a communication problem) (EDA et al., 2016). 6. History of any systemic illness, reflex sympathetic dystrophy and related syndromes e.g. rheumatoid arthritis, ankylosing spondylitis, diagnosed by physician (Heron et al., 2017 and Turgut et al., 2017). 7. Passive limitation of range of movement, stiff shoulder and less than 90 active elevation (Heron et al., 2017 and EDA et al., 2016). 8. Evidence of complete rotator cuff tear (positive drop arm test) (Heron et al., 2017).

Locations (1)

Faculty of Physical Therapy Cairo University

Cairo, Giza Governorate, Egypt

Outcomes

Primary Outcomes

shoulder function

measured by the Arabic version of the SPADI (Shoulder Pain and Disability Index) is a self-report questionnaire designed to assess shoulder pain and disability in outpatients. It consists of 13 items: a 5-item pain subscale and an 8 item disability subscale; it is widely used and available in multiple languages such as the Arabic version ;with higher values indicating greater severity.

Time frame: measured at baseline then after 6 weeks

Shoulder Pian

measured using Numerical Pain scale It is a self-reported scale where the patient rates their pain on a numerical range, usually from 0 to 10; where the zero indicate less pain and 10 worst pain

Time frame: at baseline and after 6 weeks

Secondary Outcomes

shoulder ROM(abduction and internal rotation)

measured by Digital goniometer The digital goniometer (DG)is a precise and user-friendly tool for measuring joint ROM in rehabilitation, offering real-time feedback and improved accuracy over the universal goniometer. It is commonly used for shoulder impingement assessment, helping track progress and ensures safe mobility improvements

Time frame: measured at baseline and after 6 weeks

shoulder muscle strength(UT,MT,LT,SA,ER,IR)

measured by HHD(Hand Held Dynamometer)(Lafayette) The handheld dynamometer (HHD) (model 01165, Lafayette Instrument Company, Indiana, USA)Is a reliable and objective tool for assessing isometric muscle strength, outperforming manual muscle testing. Lightweight and portable, it has strong concurrent validity, making it practical for strength evaluation. It is the preferred method for measuring shoulder rotator strength in symptomatic patients in clinical setting

Time frame: measured at baseline and after 6 weeks

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.