Comparison of specific and non-specific treatment approaches for individuals with posterior capsule tightness and shoulder impingement symptoms: A randomized controlled trial,Brazilian Journal of Physical Therapy

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Comparison of specific and non-specific treatment approaches for individuals with posterior capsule tightness and shoulder impingement symptoms: A randomized controlled trial
Brazilian Journal of Physical Therapy ( IF 3.1 ) Pub Date : 2021-05-04 , DOI: 10.1016/j.bjpt.2021.04.003
Dayana P Rosa ₁ , John D Borstad ₂ , Julia K Ferreira ₁ , Vander Gava ₁ , Rodrigo V Santos ₁ , Paula R Camargo ₁

Affiliation

Background

Posterior capsule tightness (PCT) is associated with shoulder pain and altered shoulder kinematics, range of motion (ROM), external rotation (ER) strength, and pain sensitization.

Objective

To assess the effects of two interventions on shoulder kinematics, Shoulder Pain and Disability Index (SPADI) scores, ROM, strength, and pressure pain threshold (PPT) in individuals with PCT and shoulder impingement symptoms.

Methods

In this prospectively registered randomized controlled trial 59 individuals were randomized to either an Experimental Intervention Group (EIG, n=31) or a Control Intervention Group (CIG, n=28). The low flexion (LF) test was used to determine the presence of PCT. Shoulder kinematics, SPADI scores, internal rotation (IR) and ER ROM, ER strength, and PPT were measured pre- and post-treatment. Those in the EIG received an intervention specific to pain and PCT and those in the CIG received a non-specific intervention, both 4 weeks in duration.

Results

Individuals in the EIG demonstrated more scapular upward rotation (P=.03; mean difference (MD)=3.3°; 95% Confidence Interval (CI)=1.3°, 4.9°) and improved value on the LF test (P=.02; MD=4.6°; 95%CI=0.7°, 8.6°) than those in the CIG after treatment. Both groups presented less anterior (P<.01; MD=-0.7mm; 95%CI=-1.3mm, -0.2mm) and superior (P<.01; MD=-0.5mm; 95%CI=-0.9mm, -0.2mm) humeral translations, decreased SPADI score (P<.01; MD=-23.6; 95%CI=-28.7, -18.4), increased IR ROM (P<.01; MD=4.6°; 95%CI=1.8°, 7.8°) and PPTs for upper trapezius (P<.01; MD=60.1kPa; 95%CI=29.3kPa, 90.9kPa), infraspinatus (P=.04; MD=47.3kPa; 95%CI=2.1kPa, 92.5kPa), supraspinatus (P<.01; MD=63.7kPa; 95%CI=29.6kPa, 97.9kPa), and deltoid (P<.01; MD=40.9kPa; 95%CI=12.3kPa, 69.4kPa) after treatment.

Conclusion

The experimental intervention was more effective at improving PCT as measured through changes in the LF test. No benefit of the specific approach over the non-specific intervention was noted for the remaining variables.

中文翻译：

后囊紧张和肩部撞击症状个体的特异性和非特异性治疗方法的比较：一项随机对照试验

背景

后囊紧张 (PCT) 与肩痛和肩关节运动学改变、运动范围 (ROM)、外旋 (ER) 强度和疼痛敏感有关。

客观的

评估两种干预措施对肩关节运动学、肩痛和残疾指数 (SPADI) 评分、ROM、力量和压力痛阈值 (PPT) 对患有 PCT 和肩部撞击症状的个体的影响。

方法

在这项前瞻性注册的随机对照试验中，59 个人被随机分配到实验干预组（EIG，n=31）或控制干预组（CIG，n=28）。低屈曲 (LF) 测试用于确定 PCT 的存在。在治疗前后测量肩部运动学、SPADI 评分、内旋 (IR) 和 ER ROM、ER 强度和 PPT。EIG 中的那些接受了针对疼痛和 PCT 的干预，而 CIG 中的那些接受了非特异性干预，持续时间均为 4 周。

结果

EIG 中的个体表现出更多的肩胛向上旋转（P=.03；平均差异 (MD)=3.3°；95% 置信区间 (CI)=1.3°、4.9°）和 LF 测试的改进值（P=.02 ; MD=4.6°; 95%CI=0.7°, 8.6°) 比处理后的 CIG 中的那些。两组均呈现较小的前部 (P<.01; MD=-0.7mm; 95%CI=-1.3mm, -0.2mm) 和优越 (P<.01; MD=-0.5mm; 95%CI=-0.9mm) , -0.2mm) 肱骨平移，SPADI 评分降低（P<.01；MD=-23.6；95%CI=-28.7，-18.4），IR ROM 增加（P<.01；MD=4.6°；95%CI =1.8°, 7.8°) 和上斜方肌的 PPT (P<.01; MD=60.1kPa; 95%CI=29.3kPa, 90.9kPa), 冈下肌 (P=.04; MD=47.3kPa; 95%CI= 2.1kPa, 92.5kPa)、冈上肌 (P<.01; MD=63.7kPa; 95%CI=29.6kPa, 97.9kPa) 和三角肌 ( P <.01; MD=40.9kPa; 95%CI=12.3kPa, 69.4kPa) 处理后。