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Does adding heavy load eccentric training to rehabilitation of patients with unilateral subacromial impingement result in better outcome?: a randomized, clinical trial

Annelies Maenhout UGent, Nele Mahieu UGent, Martine De Muynck UGent, Lieven De Wilde UGent and Ann Cools UGent (2013) KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 21(5). p.1158-1167
abstract
To investigate superior value of adding heavy load eccentric training to conservative treatment in patients with subacromial impingement. Sixty-one patients with subacromial impingement were included and randomly allocated to the traditional rotator cuff training (TT) group (n = 30, mean age = 39.4 +/- A 13.1 years) or traditional rotator training combined with heavy load eccentric training (TT + ET) group (n = 31, mean age = 40.2 +/- A 12.9 years). Isometric strength was measured to abduction at 0A degrees, 45A degrees and 90A degrees of scapular abduction and to internal and external rotation. The SPADI questionnaire was used to measure shoulder pain and function. Patients rated subjective perception of improvement. Outcome was assessed at baseline, at 6 and 12 weeks after start of the intervention. Both groups received 9 physiotherapy treatments over 12 weeks. At home, the TT group performed traditional rotator cuff strengthening exercises 1x/day. The TT + ET group performed the same exercises 1x/day and a heavy load eccentric exercise 2x/day. After treatment, isometric strength had significantly increased in all directions, and SPADI score had significantly decreased. The TT + ET group showed a 15 % higher gain in abduction strength at 90A degrees of scapular abduction. Chi-square tests showed patients' self-rated perception of improvement was similar in both groups. Adding heavy load eccentric training resulted in a higher gain in isometric strength at 90A degrees of scapular abduction, but was not superior for decreasing pain and improving shoulder function. This study showed that the combination of a limited amount of physiotherapy sessions combined with a daily home exercise programme is highly effective in patients with impingement.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
ROTATOR CUFF TENDINOPATHY, SHOULDER IMPINGEMENT, CHRONIC ACHILLES TENDINOSIS, Tendon, Eccentric training, Shoulder impingement syndrome, Physiotherapy, ANTERIOR ACROMIOPLASTY, DISABILITY INDEX, GENERAL-PRACTICE, PAIN, STRENGTH, EXERCISE, TENDON
journal title
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
Knee Surg. Sports Traumatol. Arthrosc.
volume
21
issue
5
pages
1158 - 1167
Web of Science type
Article
Web of Science id
000317978400024
JCR category
SPORT SCIENCES
JCR impact factor
2.837 (2013)
JCR rank
10/81 (2013)
JCR quartile
1 (2013)
ISSN
0942-2056
DOI
10.1007/s00167-012-2012-8
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2711847
handle
http://hdl.handle.net/1854/LU-2711847
date created
2012-06-18 14:17:42
date last changed
2014-01-06 09:01:03
@article{2711847,
  abstract     = {To investigate superior value of adding heavy load eccentric training to conservative treatment in patients with subacromial impingement. 
Sixty-one patients with subacromial impingement were included and randomly allocated to the traditional rotator cuff training (TT) group (n = 30, mean age = 39.4 +/- A 13.1 years) or traditional rotator training combined with heavy load eccentric training (TT + ET) group (n = 31, mean age = 40.2 +/- A 12.9 years). Isometric strength was measured to abduction at 0A degrees, 45A degrees and 90A degrees of scapular abduction and to internal and external rotation. The SPADI questionnaire was used to measure shoulder pain and function. Patients rated subjective perception of improvement. Outcome was assessed at baseline, at 6 and 12 weeks after start of the intervention. Both groups received 9 physiotherapy treatments over 12 weeks. At home, the TT group performed traditional rotator cuff strengthening exercises 1x/day. The TT + ET group performed the same exercises 1x/day and a heavy load eccentric exercise 2x/day. 
After treatment, isometric strength had significantly increased in all directions, and SPADI score had significantly decreased. The TT + ET group showed a 15 \% higher gain in abduction strength at 90A degrees of scapular abduction. Chi-square tests showed patients' self-rated perception of improvement was similar in both groups. 
Adding heavy load eccentric training resulted in a higher gain in isometric strength at 90A degrees of scapular abduction, but was not superior for decreasing pain and improving shoulder function. This study showed that the combination of a limited amount of physiotherapy sessions combined with a daily home exercise programme is highly effective in patients with impingement.},
  author       = {Maenhout, Annelies and Mahieu, Nele and De Muynck, Martine and De Wilde, Lieven and Cools, Ann},
  issn         = {0942-2056},
  journal      = {KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY},
  keyword      = {ROTATOR CUFF TENDINOPATHY,SHOULDER IMPINGEMENT,CHRONIC ACHILLES TENDINOSIS,Tendon,Eccentric training,Shoulder impingement syndrome,Physiotherapy,ANTERIOR ACROMIOPLASTY,DISABILITY INDEX,GENERAL-PRACTICE,PAIN,STRENGTH,EXERCISE,TENDON},
  language     = {eng},
  number       = {5},
  pages        = {1158--1167},
  title        = {Does adding heavy load eccentric training to rehabilitation of patients with unilateral subacromial impingement result in better outcome?: a randomized, clinical trial},
  url          = {http://dx.doi.org/10.1007/s00167-012-2012-8},
  volume       = {21},
  year         = {2013},
}

Chicago
Maenhout, Annelies, Nele Mahieu, Martine De Muynck, Lieven De Wilde, and Ann Cools. 2013. “Does Adding Heavy Load Eccentric Training to Rehabilitation of Patients with Unilateral Subacromial Impingement Result in Better Outcome?: a Randomized, Clinical Trial.” Knee Surgery Sports Traumatology Arthroscopy 21 (5): 1158–1167.
APA
Maenhout, A., Mahieu, N., De Muynck, M., De Wilde, L., & Cools, A. (2013). Does adding heavy load eccentric training to rehabilitation of patients with unilateral subacromial impingement result in better outcome?: a randomized, clinical trial. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 21(5), 1158–1167.
Vancouver
1.
Maenhout A, Mahieu N, De Muynck M, De Wilde L, Cools A. Does adding heavy load eccentric training to rehabilitation of patients with unilateral subacromial impingement result in better outcome?: a randomized, clinical trial. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 2013;21(5):1158–67.
MLA
Maenhout, Annelies, Nele Mahieu, Martine De Muynck, et al. “Does Adding Heavy Load Eccentric Training to Rehabilitation of Patients with Unilateral Subacromial Impingement Result in Better Outcome?: a Randomized, Clinical Trial.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 21.5 (2013): 1158–1167. Print.