title: Effects of weighted and un-weighted pendulum exercises on ultrasonographic acromiohumeral distance in patients with subacromial impingement syndrome.
abstract: BACKGROUND
  Although functional results of combined rehabilitation programs are reported, there have been no reports studying the effects of solo pendulum exercises on ultrasonographic measurements of acromiohumeral distance (AHD).
  
  
  OBJECTIVE
  To investigate the effects of weighted and un-weighted pendulum exercises on ultrasonographic AHD and clinical symptoms in patients with subacromial impingement syndrome.
  
  
  METHODS
  Patients with subacromial impingement syndrome were randomized to performing weighted (1.5 kilograms hand held dumbbell, N= 18) or un-weighted (free of weight, N= 16) pendulum exercises for 4 weeks, 3 sessions/day. Exercises were repeated for each direction of shoulder motion in each session (ten minutes). Clinical situation was evaluated by Constant score and Shoulder Pain Disability Index (SPADI). Ultrasonographic measurements of AHD at 0°, 30° and 60° shoulder abduction were performed. All clinical and ultrasonographic evaluations were performed at the beginning of the exercise program and at end of 4 weeks of exercise program.
  
  
  RESULTS
  Thirty-four patients (23 females, 11 males; mean age 41.7 ± 8.9 years) were evaluated. Significant clinical improvements were detected in both exercise groups between pre and post-treatment evaluations (p < 0.05). There was no significant difference for pre and post-treatment AHD measurements at 0°, 30°, and 60° shoulder abduction between groups (p > 0.05). There was no significant difference for pre and post-treatment narrowing of AHD (narrowing of 0°-30°, and 0°-60°) between groups (p > 0.05).
  
  
  CONCLUSIONS
  While significant clinical improvements were achieved with both weighted and un-weighted solo pendulum exercises, no significant difference was detected for ultrasonographic AHD measurements between exercise groups.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Nuray
authors.initials: N
authors.lastname: Akkaya
authors.affiliation: Department of Orthopedics and Traumatology, Pamukkale University, Denizli, Turkey.
authors.forename: Semih
authors.initials: S
authors.lastname: Akkaya
authors.affiliation: Department of Orthopedics and Traumatology, Pamukkale University, Denizli, Turkey.
authors.forename: Harun R
authors.initials: HR
authors.lastname: Gungor
authors.affiliation: Department of Physical and Rehabilitation Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Gokce
authors.initials: G
authors.lastname: Yaşar
authors.affiliation: Department of Physical and Rehabilitation Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Nilgun Simsir
authors.initials: NS
authors.lastname: Atalay
authors.affiliation: Department of Physical and Rehabilitation Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Fusun
authors.initials: F
authors.lastname: Sahin
mesh_terms: D000174:Acromion / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology*; D012782:Shoulder / Q000000981:diagnostic imaging / Q000503:physiopathology; D019534:Shoulder Impingement Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Acromiohumeral distance; codman exercises; pendulum exercises; subacromial impingement syndrome; ultrasonography