Individual, group or home exercise for subacromial pain

Which is most effective in terms of clinical outcomes and associated healthcare costs?

Shoulder disorders are common in the community, with up to half of the population experiencing at least one episode each year. The most common source of pain is irritation of the musculotendinous rotator cuff and bursa, which are located under the acromion (the point of the shoulder).

Subacromial pain responds well to exercise therapy, with improvements in pain, mobility and function. However, until now, the most effective format for the delivery of this exercise rehabilitation is unknown. Do patients need individual one-to-one supervision with a physiotherapist to achieve these benefits? Or could group-based exercise be just as effective? And what of patients in lockdown: could they achieve the same benefits with home exercise?


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