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Supervised vs. home exercise in subacromial pain syndrome

Which has better results?

In this review, no significant differences in pain, function, and shoulder range of motion were found between supervised physiotherapy and a home-based progressive strengthening/ stretching programme in patients with subacromial pain syndrome.

However, the authors caution that these findings should be interpreted carefully, since there was a lack of a standardised supervised physiotherapy programme across the included studies.

Risk of bias was high in 2 studies, medium in 2 studies, and low in 3 studies. The mean differences in function, pain (VAS), and range of motion (degrees) were -0.14 points, 0.21 cm, and 0.62 degrees, respectively.

Although study heterogeneity was observed for pain and function, the authors conclude that both approaches yielded similar results in patients with subacromial pain syndrome.

The authors suggest that future studies should aim to standardise interventions and define subacromial pain syndrome more clearly.

> From: Gutiérrez-Espinosa et al., Phys Ther Sport 41 (2019) 34-42 (Epub ahead of print). All rights reserved to Elsevier Ltd. Click here for the online summary.

Expert opinion

The results found in this review may be associated with the lack of specificity associated with subacromial pain syndrome.

As mentioned by the authors, the definition of this condition is unclear, and it may be more characterised by movement disorders rather than identifiable anatomic features clearly associated with symptoms.

As such, due to the lack of specificity of the condition, a home-based shoulder progressive strengthening program may be as useful as supervised interventions since they generally improve shoulder physical qualities.

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