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The Effect of the Addition of Core Exercises to Supervised Physiotherapy in Patients With Subacromial Impingement Syndrome

Abstract:

Background Weakness of the rotator cuff has been reported in patients with subacromial impingement syndrome (SIS). A novel therapeutic approach proposes adding exercises for the core musculature to aid in functional recovery in these patients. Purpose The aim of this study was to assess the short-term effects of adding a core exercise program to supervised physiotherapy on improve lateral rotator strength and functional outcomes in patients with SIS. Study Design A pre–post single-group study. Methods A total of 47 participants with SIS were recruited. All patients were treated with five weeks of supervised physiotherapy plus a core exercise program. The primary outcomes were isometric lateral rotator strength and grip strength, measured with a dynamometer. Secondary outcomes included muscular endurance assessed with the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), shoulder function with the Constant-Murley (CM) questionnaire, and pain intensity reported using the Visual Analog Scale (VAS). Need a brief statement of statistical approach. Results At end of the five week intervention, isometric lateral rotator strength showed an increase of 9.2 kg (d = 2.1; p < 0.001) and grip strength an increase of 10.6 kg (d = 2.4; p < 0.001). The CKCUEST showed an increase of 5.6 repetitions (d = 3.7; p < 0.001), the CM questionnaire showed an increase of 30.3 points (d = 4.9; p < 0.001) and the VAS showed a decrease of 3.9 cm (d = 6.0; p < 0.001). All outcomes showed large effect sizes and statistically significant differences. Conclusion In the short term, adding a core exercise program to supervised physiotherapy showed statistically and clinically significant differences in lateral rotator strength and functional outcomes in patients with SIS. Level of Evidence Level 3.