title: Home exercises and supervised exercises are similarly effective for people with subacromial impingement: a randomised trial.
abstract: OBJECTIVE
  Are there different effects of home exercises and supervised exercises on pain and disability for people with subacromial impingement?
  
  
  METHODS
  Randomised trial with two treatment arms, concealed allocation, blinded assessment of some outcomes, and intention-to-treat analysis.
  
  
  METHODS
  Forty-six patients with subacromial impingement were recruited from an interdisciplinary outpatient clinic of physical medicine and rehabilitation at a university hospital in Norway.
  
  
  METHODS
  The home exercise group had one supervised exercise treatment followed by exercises at home for 6 weeks. The supervised exercise group had up to 10 supervised exercise treatments in addition to home exercises for 6 weeks.
  
  
  METHODS
  The primary outcome was the Shoulder Pain and Disability Index (SPADI). Secondary outcome variables were: average pain during the past week, the Fear Avoidance Beliefs Questionnaire, participant satisfaction with treatment, active range of motion, work status and clinical shoulder tests. Pain was assessed weekly and all outcomes were assessed at 6 weeks. Participants were free to seek ongoing treatment of their choice until 26 weeks, when the SPADI was assessed again.
  
  
  RESULTS
  While both groups improved considerably, the groups did not differ significantly on the SPADI after the intervention at 6 weeks (0 points, 95% CI -14 to 14) or when followed up at 26 weeks (-2 points, 95% CI -21 to 17). There were no between-group differences for pain at any time. The remaining outcomes also did not differ significantly, except for the clinical tests of shoulder impingement. In the supervised exercise group, 11 out of 23 participants had two or more positive tests, compared to 18 out of 21 in the home exercise group.
  
  
  CONCLUSIONS
  Supervision of more than the first session of a 6-week exercise regimen did not cause significant differences in pain and disability in people with subacromial impingement.
  
  
  BACKGROUND
  NCT01257113.
authors.affiliation: Department of Physical Medicine and Rehabilitation, St. Olav's University Hospital.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Granviken
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Ottar
authors.initials: O
authors.lastname: Vasseljen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012648:Self Care / Q000379:methods*; D019534:Shoulder Impingement Syndrome / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Exercise therapy; Randomised controlled trial; Rehabilitation; Shoulder; Subacromial impingement syndrome