[Self-training versus conventional physiotherapy in subacromial impingement syndrome].
OBJECTIVE
This prospective, randomized study was aimed to compare the effect of a standardized self-training versus standard physiotherapist-supervised exercises in the non-operative treatment of shoulder impingement syndrome types Neer I and II.


METHODS
40 patients with subacromial impingement I/II were randomized to two groups. Group 1 performed a mostly isometric self-training after instruction by a physiotherapist, group 2 received prescriptions for physiotherapy and "strengthening exercises for the rotator cuff". Follow up was performed after 6 and 12 weeks with the use of the constant score (unpondered). Patient satisfaction with the treatment was controlled by VAS (1 - 6).


RESULTS
After 12 weeks, patients of group 1 had performed the exercises 5 x/week for 15 minutes. Patients of group 2 had received 30 sessions in average. Patients of group 1 improved from a mean of 59 points (39.5 - 86) to a mean of 68 points (37 - 88) after 6 and 75 points (65 - 90) after 12 weeks. Patients of group 2 improved from 60.5 points (41 - 83) to 67 points (39.5 - 92) and 72 points (43 - 93), respectively. Patient satisfaction was higher in the self-training group (1.9 : 2.8).


CONCLUSIONS
Strengthening of the centering muscles around the humeral head leads to good results in the non-operative treatment of subacromial impingement. Self-training after instruction showed no difference to physiotherapist-supervised exercises in the non-operative treatment of subacromial impingement.
Orthopädische Klinik, Universitätsklinikum Düsseldorf. werner@med.uni-duesseldorf.de
A
A
Werner
M
M
Walther
A
A
Ilg
T
T
Stahlschmidt
F
F
Gohlke
D000328:Adult; D000368:Aged; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007537:Isometric Contraction; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D012648:Self Care; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis / Q000534:rehabilitation*