Effects of comprehensive physiotherapy compared with routine physiotherapy on pain and function in patients with subacromial pain syndrome: A randomized clinical trial with 6-month follow-up

Abstract

Objective: The present study aimed to compare the effects of two treatment methods, including comprehensive physiotherapy (CPT), and routine physiotherapy (RPT) on pain, function, and quality of life in patients with subacromial pain syndrome (SAPS).

Methods: Forty patients with SAPS were randomly allocated into two groups. The RPT group (7 males, 13 females), (56.45 ± 9.65 years) received manual therapy and exercise therapy for shoulder joint. The CPT group (8 males, 12 females), (52.20 ± 7.39 years) received the above treatments administered to the RPT group plus scapular muscle stretching and strengthening exercise, scapular muscle motor control retraining, thoracic mobilization, and postural correction. Pain (visual analog scale; VAS), function (shoulder pain and disability index; SPADI and quick version of shoulder and hand questionnaire; quick DASH), and quality of life (Western Ontario rotator cuff questionnaire; WORC) were measured before, immediately, one, and six months after treatment.

Results: Interaction of group by time was significant for pain (VAS) (f = 3.79, p = 0.01, partial eta-squared (ηp ² = 0.103), quick DASH (f = 5.34, p = 0.003, ηp ² = 0.139, WORC (f = 3.99, p = 0.01, ηp ² = 0.207) and was not significant for SPADI total score (f = 2.45, p = 0.07, ηp ² = 0.069). Although the two groups were similar immediately and 1 month post intervention, the CPT group performed better than the RPT group 6 months after intervention. At 6-month assessment, more patients in the CPT group reached the minimal clinically important differences as compared to control groups.

Conclusions: After six months, CPT was found to be more effective than RPT in improving pain, function, and quality of life.

Keywords: Exercise; Motion; Posture; Scapular training; Shoulder; Subacromial pain syndrome.