title: Effects of a movement training oriented rehabilitation program on symptoms, functional limitations and acromiohumeral distance in individuals with subacromial pain syndrome.
abstract: BACKGROUND
  Multiple factors have been associated with the presence of a subacromial pain syndrome (SPS), including deficits in performance of scapular and glenohumeral muscles. Such deficits can lead to inadequate kinematics and decreased acromiohumeral distance (AHD). Exercises that aim at correcting these deficits, such as movement training, were suggested to improve symptoms and functional limitations. To date, few studies have assessed outcomes following an intervention focused on movement training.
  
  
  OBJECTIVE
  Evaluate the effects of a rehabilitation program based on movement training on symptoms, functional limitations and AHD in individuals with SPS.
  
  
  METHODS
  Prospective single group pre-post design.
  
  
  METHODS
  Twenty-five participants with SPS (SPS group) participated in a 6-week program. Twenty asymptomatic volunteers were recruited for normative AHD values (control group). Outcomes of both groups were evaluated at baseline and 6 weeks, i.e. immediately following intervention for the SPS group. Changes in symptoms and functional limitations for SPS group were assessed using the Western Ontario Rotator Cuff (WORC) index and Disability of the Arm Shoulder and Hand (DASH) questionnaire. Changes in AHD for both groups were assessed using ultrasonographic measures.
  
  
  RESULTS
  Following the rehabilitation program, the scores on WORC and DASH were significantly improved (p < 0.001). AHD increased significantly in the SPS group (p = 0.019), especially in a subgroup with initial deficits (p < 0.001).
  
  
  CONCLUSIONS
  The rehabilitation program yielded improvements in symptoms and functional limitations in participants with SPS. Moreover, it led to an increase of the AHD--thus potentially decreasing subacromial compression, particularly in participants with an initially smaller AHD. The trial was registered at ClinicalTrials.gov: identifier--NCT02395770.
authors.affiliation: Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada G1M 2S8. Electronic address: alexandre.savoie@fmed.ulaval.ca.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Savoie
authors.affiliation: Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada G1M 2S8; Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada G1R 1P5. Electronic address: catherine.mercier@rea.ulaval.ca.
authors.forename: Catherine
authors.initials: C
authors.lastname: Mercier
authors.affiliation: Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada. Electronic address: f.desmeules@umontreal.ca.
authors.forename: François
authors.initials: F
authors.lastname: Desmeules
authors.affiliation: Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada G1R 1P5; Centre de recherche du Centre Hospitalier Universitaire de Québec, Quebec City, Quebec, Canada. Electronic address: pierre.fremont@fmed.ulaval.ca.
authors.forename: Pierre
authors.initials: P
authors.lastname: Frémont
authors.affiliation: Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada G1M 2S8; Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada G1R 1P5. Electronic address: jean-sebastien.roy@rea.ulaval.ca.
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Roy
mesh_terms: D000174:Acromion / Q000033:anatomy & histology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000033:anatomy & histology; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D020127:Recovery of Function; D055070:Resistance Training / Q000379:methods; D018570:Risk Assessment; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis / Q000534:rehabilitation*; D020069:Shoulder Pain / Q000175:diagnosis / Q000534:rehabilitation*; D018608:Ultrasonography, Doppler; D055815:Young Adult
keywords: Motor control; Motor learning; Shoulder pain; Ultrasonographic measures