Article

Little is known about the effectiveness of exercise programs after
decompression surgery for subacromial impingement syndrome. For patients with
difficulty returning to usual activities, special efforts may be needed to
improve shoulder function.
The purpose of this study was to evaluate
the effectiveness at 3 and 12 months of a standardized physical therapy exercise
intervention compared with usual care in patients with difficulty returning to
usual activities after subacromial decompression surgery. DESIGN: A multicenter
randomized controlled trial was conducted. SETTING: The study was conducted in 6
public departments of orthopedic surgery, 2 departments of occupational medicine,
and 2 physical therapy training centers in Central Denmark Region. PATIENTS: One
hundred twenty-six patients reporting difficulty returning to usual activities at
the postoperative clinical follow-up 8 to 12 weeks after subacromial
decompression surgery participated. INTERVENTION: A standardized exercise program
consisting of physical therapist-supervised individual training sessions and home
training was used. OUTCOME MEASURES: The primary outcome measure was the Oxford
Shoulder Score. Secondary outcome measures were the Constant Score and the
Fear-Avoidance Beliefs Questionnaire. RESULTS: At 3 and 12 months, follow-up data
were obtained for 92% and 83% of the patients, respectively. Intention-to-treat
analyses suggested a between-group difference on the Oxford Shoulder Score
favoring the exercise group at 3 months, with an adjusted mean difference of 2.0
(95% confidence interval=-0.5, 4.6), and at 12 months, with an adjusted mean
difference of 5.8 (95% confidence interval=2.8, 8.9). Significantly larger
improvements for the exercise group were observed for most secondary and
supplementary outcome measures. LIMITATIONS: The nature of the exercise
intervention did not allow blinding of patients and care providers. CONCLUSION:
The standardized physical therapy exercise intervention resulted in statistically
significant and clinically relevant improvement in shoulder pain and function at
12 months compared with usual care.
CI - (c) 2016 American Physical Therapy Association.

Langue : ANGLAIS