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· DOS Abstracts
Physiotherapy improves patient reported shoulder
function and health status in patients with
subacromial impingement syndrome
Filip Holst Storgaard, Christina Gravgaard Pedersen, Majbritt Lykke Jensen,
Steen Lund Jensen
Physiotherapy, Aalborg University Hospital; Orthopaedic, Aalborg University
Hospital
Background:
Physiotherapy may be as effective as surgery in the treatment
of subacromial impingement syndrome (impingement). According to National
Clinical Guidelines, patients with impingement should have recieved at least
three months of physiotherapy before surgery is considered.
Purpose / Aim of Study:
To report the outcome of a standardized physio-
therapy based treatment regimen for impingement.
Materials and Methods:
An orthopaedic shoulder specialist provisionally se-
lects patients from referrals. The physiotherapist makes a final diagnosis of im-
pingement based on clinical findings and radiographs, and initiates a 3-6 months
rehabilitation program including rotator cuff strengthening, posture correction
and scapula setting. Treatment efficacy is monitored by Oxford Shoulder Score
(OSS) and EQ- 5D-5L, using web based software and email communication
(Procordo).
Findings / Results:
The first year 222 patients (mean age 53 years, 121
males) were included for physiotherapy and patient reported outcome. Home-
based response rates were 92% and 82% after 4 and 12 months. The mean
OSS scores at inclusion, after 4 months and after 12 months were 30.3, 35.3
and 38.4 respectively (p<0.001). The corresponding EQ-5D-5L index values
were 0.79, 0.82 and 0.86 (p<0.001). 31 had clinically unsatisfactory results,
and were seen by shoulder surgeon (mean OSS improvement at 4 months -1.3
compared with 5.9 for those treated exclusively by physiotherapist); 24 had
surgery.
Conclusions:
Patients with impingement managed by a physiotherapy regi-
men improve self- perceived shoulder function and health status. Improvement
continues during the first year, even after formal physiotherapy is stopped. Only
few patients need evaluation for surgery. Measuring patient reported outcome
with a web based software and email is feasible and provide high response rates
in this patient group.
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