Guided Exercises With Or Without Joint Mobilization Or No Treatment In Patients With Subacromial Pain Syndrome: A Clinical Trial

Background: Graded resistance training is the recom & shy; mended treatment for patients with subacromial pain syndrome. It is debated whether adding joint mo & shy; bilization will improve the outcome. The aim of this study was to evaluate the clinical outcome of guided exercises with or without joint mobilization, compar & shy; ed with controls who did not receive any treatment.Methods: A 3 & shy;armed controlled trial in a primary care setting. A total of 120 patients, with clinically diag & shy; nosed subacromial pain syndrome, were randomized into guided exercise groups with and without ad & shy; ditional joint mobilization, and a control group that did not receive any treatment. Data were analysed at baseline, 6 weeks, 12 weeks and 6 months. Primary outcome was the Constant & shy;Murley score, and second & shy; ary outcomes were pain and active range of motion.Results: Shoulder function improved in all groups, as measured with the Constant & shy;Murley score. At 12 weeks and 6 months the exercise groups improved significantly compared with the con & shy; trol group (p <= 0.05). Add-on joint mobilization resulted in decreased pain in active range of mo & shy; tion at 6 and 12 weeks compared with guid ed ex & shy; ercise or no treatment (p <= 0.05). Range of motion increased over time in all 3 groups.Conclusion: In patients with subacromial pain syn & shy; drome guided exercises improved shoulder function compared with no treatment. Add & shy;on joint mobiliza & shy; tion decreased pain in the short & shy;term compared with exercise alone or no treatment.