ABSTRACT
Background: Shoulder Impingement is one of the most common causes of shoulder pain in adults. Scapular muscle imbalances results in impaired scapular orientation with altered scapular kinematics and altered glenohumeral rhythm. Purpose of study: To study the effect of motor control retraining of scapular stabilizers versus mulligan mobilisation with movement in shoulder impingement patients. Methodology: 60 patients with positive Hawkins, kinetic medial rotation and/or Neer impingement test were taken for the study as subjects. They were then divided into two groups of 30 each- Group A and Group B. Both the groups were assessed and reassessed for(i) pain status using VAS (Visual Analogue Scale) both at rest and on internal rotation, (ii)Shoulder Flexion, Extension, Shoulder Abduction, Adduction, Internal and External Rotation Range Of Motion (ROM), (iii)Functional Scale SPADI( Shoulder Pain and Disability Index) pre and post the intervention. Group A received motor control retraining of scapular stabilizers whereas group B received Mulligan’s mobilization with movement for 6 weeks (3 times in a week). Both the groups received conventional physiotherapy. Data analysis was done using Wilcoxon sign ranked test for intragroup comparison and Manwhitney test for intergroup comparison. Results: The results showed statistically significant improvement in shoulder pain, ROM and shoulder function in motor control retraining as compared to mulligan mobilisation with movement. Conclusion: Motor control retraining of scapular stabilizers is more effective treatment technique as compared to mulligan mobilisation with movement in shoulder impingement.
ABSTRACT
Background: Alteration in upper body posture is associated with shoulder impingement due to changes in scapular orientation, increased thoracic kyphosis and concomitant imbalance of glenohumeral and scapulothoracic muscles. Mechanical correction of scaular and thoracic posture can reduce impingement. Recently use of kinesiotapes has been increasingly popular. There have been some studies reporting the effect of kinesiotapes on muscle activation and pain reduction in subacromial impingement syndrome. Kinesiotapes can also be used to correct scapular and thoracic posture in Subacromial Impingement Syndrome. Purpose of study: To study the effect of scapula and thoracic taping using kinesiotapes in addition of conventional treatment on scapular posture and shoulder range of motion in Subacromial Impingement Syndrome. Materials and Methods: 60 subjects with Subacromial Impingement Syndrome were randomly assigned to two groups. Experimental group received scapula and thoracic taping using kinesiotape for 24hrs along with conventional physiotherapy treatment. Control group received conventional physiotherapy. Subjects were assessed pre, immediate post intervention and 24hr post intervention for scapular posture, shoulder range of motion and pain. Results: Experimental group showed statistical significant improvement(p<0.001) in scapular posture, shoulder range of motion and pain (on medial rotation, and reaching the back) scores both immediately and 24hour post intervention compared to control group. Also greater improvement was seen in pain and range of motion post 24 hour as compared to immediate post intervention in experimental group. Conclusion: Taping as an adjunct to conventional treatment is much more effective for short term improvement in scapular postures, range of motion and reduction in pain as compared to only conventional treatment in subjects with Subacromial Impingement Syndrome.