Patients with Subacromial Pain Syndrome Present no Reduction of Shoulder Proprioception: A Matched Case-Control Study.

BACKGROUND: Shoulder pain is common among patients with musculoskeletal pain and the prevalence of patients with subacromial pain syndrome (SAPS) is high. Despite the high prevalence, there is a lack of an extensive evaluation of the proprioception acuity in patients with SAPS. Knowledge of the proprioceptive deficit would assist clinicians in the proper treatment and may offer an alternative explanation for the mechanisms underlying SAPS, which are poorly understood. OBJECTIVE: To compare the proprioceptive function of the shoulder in patients with SAPS and matched controls. STUDY DESIGN: Matched case-control study. SETTING: Physical Functional Rehabilitation Service of an outpatient clinic. PARTICIPANTS: A total of 32 consecutive patients with SAPS who sought physical therapy for shoulder pain and 32 healthy participants (control group) matched for age, sex, and handedness. INTERVENTIONS: All participants completed a questionnaire containing sociodemographic information, pain intensity and characteristics, the Numerical Pain Rating Scale, and the Shoulder Pain and Disability Index. MAIN OUTCOME MEASUREMENTS: The proprioceptive assessment was performed through kinesthesia, passive joint position sense (PJPS), and the active joint position sense (AJPS). RESULTS: The groups showed no statistically significant differences in kinesthesia, PJPS, and AJPS for internal or external rotation. The proprioceptive acuity was not associated with pain intensity or functional disability in patients with SAPS. CONCLUSIONS: Participants with SAPS did not present proprioceptive deficits in a pain-free motion of medial and lateral rotation when compared to their matched controls. The proprioceptive deficit may not be involved with the mechanisms underlying SAPS and seems not to interfere with the clinical outcomes of patients with SAPS. LEVEL OF EVIDENCE: Level III.

Comparison of two proposed guidelines for aerobic training sessions.

The purpose was to compare 24 participants' acute physiological and affective responses to two aerobic prescriptions in three sessions. Anthropometry, International Physical Activity Questionnaire, and VO2max were recorded. In subsequent visits two aerobic prescriptions were randomly applied: one based on VO2max (PBVO2max) and another based on physical activity level (PBPA). Physiological and affective variables were measured in each session. The PBVO2max showed lower risk for dropout than the PBPA. An effect size analysis showed higher ratings on the Feeling Scale in the PBVO2max session at the end of exercise. After categorizing participants by fitness (High, Medium, and Low) according to VO2max, significant differences were observed for the training impulse between Low and High fitness categories, indicating PBVO2Max were sensitive in distinguishing levels of fitness. The PBVO2max, compared to PBPA, seems to provide better physiological and affective responses. VO2max (even if estimated) is recommended as the basis for aerobic prescriptions.