Title: Effect of Exercise Program on Acromiohumeral Distance in Subacromial Impingement Syndrome
Authors: Lilian Albert Zaky, Nagy Ahmed Zaki Mostafa Sabet, Maha Mostafa Mohamed, Ahmed Elhamy Mosad
DOI: http://dx.doi.org/10.18535/jmscr/v4i5.30
Abstract
Among painful shoulder conditions, Shoulder Subacromial impingement syndrome is the most common cause, Acromiohumeral distance changes commonly reported in shoulder impingements.
Objective: of this study was to evaluate the association between Acromio Humeral distance (AHD) changes and pain and upper limb function before and after physiotherapy rehabilitation program in patients with Subacromial impingement (SIS) using ultrasonographic imaging.
Methods: Fifteen patients suffered from shoulder impingement were recruited for this study. Their age ranged from 25-45 years. Acromiohumeral distance was examined by using the Ultrasonography at three abduction angles (0,45,60) Pain level was assessed by Visual analog scale and Upper extremity function was assessed using Disability of the arm shoulder and hand questioner.
Patients were assessed before the study and an exercise rehabilitation program that lasted for four weeks then reassessed again.
Design: prospective single group pre-post design
Results: showed significant changes in all measured variables as a result of the therapeutic exercise program. The results proved that Exercise not only improved AcromioHumeral distance at all abduction angles.
Conclusion: Therapeutic exercise programs have a positive effect on the size of the Subacromial space confirming the external mechanism of shoulder impingement.
Keywords: Shoulder Subacromial impingement, Ultrasonography, Acromiohumeral distance, Therapeutic exercises, Shoulder imaging.
References
1. Van der Heijden, G.J., Shoulder disorders: a state-of-the-art review. Baillieres Best Pract Res Clin Rheumatol, 2000. 13(2): p. 287-309.
2. Neer, C.S., Anterior Acromioplasty for the Chronic Impingement Syndrome in the Shoulder. 2005.
3. Ludewig, P.M. and J.P. Braman, Shoulder Impingement: Biomechanical Considerations in Rehabilitation. Manual therapy, 2011. 16(1): p. 33-39.
4. Chen, S.K., et al., Radiographic evaluation of glenohumeral kinematics: a muscle fatigue model. J Shoulder Elbow Surg, 1999. 8(1): p. 49-52.
5. Deutsch, A., et al., Radiologic measurement of superior displacement of the humeral head in the impingement syndrome. Journal of Shoulder and Elbow Surgery, 1996. 5(3): p. 186-193.
6. Seitz, A.L., et al., Mechanisms of rotator cuff tendinopathy: intrinsic, extrinsic, or both? Clinical biomechanics, 2011. 26(1): p. 1-12.
7. McCreesh, K., et al., Validation of ultrasound measurement of the subacromial space using a novel shoulder phantom model. Ultrasound in medicine & biology, 2014. 40(7): p. 1729-1733.
8. Ainsworth, R. and J.S. Lewis, Exercise therapy for the conservative management of full thickness tears of the rotator cuff: a systematic review. British journal of sports medicine, 2007. 41(4): p. 200-210.
9. Kuhn, J.E., Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. Journal of shoulder and elbow surgery, 2009. 18(1): p. 138-160.
10. Pijls, B., et al., Reliability study of the sonographic measurement of the acromiohumeral distance in symptomatic patients. Journal of Clinical Ultrasound, 2010. 38(3): p. 128-134.
11. Boonstra, A.M., et al., Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. International Journal of Rehabilitation Research, 2008. 31(2): p. 165-169.
12. Hudak, P.L., et al., Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder, and hand). American journal of industrial medicine, 1996. 29(6): p. 602-608.
13. Ellenbecker, T.S. and A. Cools, Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review. British journal of sports medicine, 2010. 44(5): p. 319-327.
14. Flatow, E.L., et al., Excursion of the rotator cuff under the acromion patterns of subacromial contact. The American Journal of Sports Medicine, 1994. 22(6): p. 779-788.
15. Michener, L.A., P.W. McClure, and A.R. Karduna, Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clinical biomechanics, 2003. 18(5): p. 369-379.
16. An, K.N., et al., Three‐dimensional kinematics of glenohumeral elevation. Journal of Orthopaedic Research, 1991. 9(1): p. 143-149.
17. Kalra, N., et al., Effect of posture on acromiohumeral distance with arm elevation in subjects with and without rotator cuff disease using ultrasonography. journal of orthopaedic & sports physical therapy, 2010. 40(10): p. 633-640.
18. Mayerhoefer, M.E., et al., Shoulder impingement: relationship of clinical symptoms and imaging criteria. Clinical Journal of Sport Medicine, 2009. 19(2): p. 83-89.