title: Shoulder impingement: the effect of sitting posture on shoulder pain and range of motion.
abstract: The re-education of spinal posture is an integral part of shoulder impingement management yet supporting evidence is limited. The purpose of this study was to evaluate the effect of slouched versus erect sitting posture on shoulder pain intensity and range of motion (ROM) in subjects with impingement. A same-subject repeated-measures design was utilized. Maximum active shoulder flexion and associated pain intensity were measured in 28 subjects in slouched and erect sitting postures, using video-analysis and visual analogue scales, respectively. An intra-tester reliability study of the video-analysis system was completed and intra-class correlation coefficients calculated. Shoulder flexion differences between slouched and erect sitting posture were analysed using a repeated-measures analysis of variance (ANOVA). The intra-tester reliability of the video-analysis method was found to be 'excellent' (ICC = 0.99). Flexion ROM was significantly greater in the erect sitting posture (F = 100.3, P < 0.0001); the mean ROM difference between postures was 17.67 degrees (+/- 9.17 degrees). There was no significant difference in pain intensity between postures (F = 1.9, P = 0.179). An erect sitting posture appeared to increase active shoulder flexion in subjects with shoulder impingement, although there were no differences in reported pain intensity. Further research is required to investigate the long-term effects of postural re-education.
authors.affiliation: Physiotherapy Department, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. mbullock@ncht.trent.nhs.uk
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bullock
authors.forename: Nadine E
authors.initials: NE
authors.lastname: Foster
authors.forename: Chris C
authors.initials: CC
authors.lastname: Wright
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010147:Pain Measurement; D011187:Posture; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012307:Risk Factors; D019534:Shoulder Impingement Syndrome / Q000150:complications / Q000503:physiopathology*; D020069:Shoulder Pain / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D011795:Surveys and Questionnaires