149 Comprehensive supervised heavy training program versus home training regimen in patients with subacromial impingement syndrome: a randomized trial

Objectives

There is no consensus on the best training regimen for subacromial impingement syndrome (SIS). Several have been suggested, but never tested. In this study, we hypothesized, that a supervised exercise protocol (STR) based on motion, stretching, and muscle and tendon strengthening with heavy slow resistance training and focus on both scapula stabilizing muscles, and rotator cuff tendons, would be superior to a simpler home exercise program that resulted in higher function score, and shoulder satisfaction than the untreated control group

Materials and Methods

Randomised control trial with blinded assessor. 126 consecutive patients with SIS were recruited and equally randomised to 12 weeks of either supervised training regimen (STR), or home-based training regimen (HTR). Primary outcomes were Constant Score (CS) and Shoulder Rating Questionnaire (SRQ) from baseline and 6 months after completed training. Results were analyzed according to intention-to treat principles.

Results

CS improved by 22.7 points for the STR group and by 23,7 points for the HTR (p=0.0001). The SRQ improved by 17.7 and 18.1 points for the STR and the HTR groups respectively (p=0.0001). The inter-group changes were non-significant. All secondary outcomes (passive and active range of motion, pain on impingement test, and resisted muscle tests) improved in both groups, without significant inter-group difference.

Conclusion

We found no significant difference between a comprehensive supervised training regimen including heavy training principles, and a home-based training program in patients with SIS.