Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome: Randomized Controlled Trial

David Høyrup Christiansen, Poul Frost, Deborah Falla, Jens Peder Haahr, Lars Henrik Frich, Linda Christie Andrea, Susanne Wulff Svendsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

BACKGROUND: Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness at 3 and 12 months of a standardized physical therapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery.

DESIGN: A multicenter randomized controlled trial was conducted.

SETTING: The study was conducted in 6 public departments of orthopedic surgery, 2 departments of occupational medicine, and 2 physical therapy training centers in Central Denmark Region.

PATIENTS: One hundred twenty-six patients reporting difficulty returning to usual activities at the postoperative clinical follow-up 8 to 12 weeks after subacromial decompression surgery participated.

INTERVENTION: A standardized exercise program consisting of physical therapist-supervised individual training sessions and home training was used.

OUTCOME MEASURES: The primary outcome measure was the Oxford Shoulder Score. Secondary outcome measures were the Constant Score and the Fear-Avoidance Beliefs Questionnaire.

RESULTS: At 3 and 12 months, follow-up data were obtained for 92% and 83% of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months, with an adjusted mean difference of 2.0 (95% confidence interval=-0.5, 4.6), and at 12 months, with an adjusted mean difference of 5.8 (95% confidence interval=2.8, 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcome measures.

LIMITATIONS: The nature of the exercise intervention did not allow blinding of patients and care providers.

CONCLUSION: The standardized physical therapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and function at 12 months compared with usual care.

OriginalsprogEngelsk
TidsskriftPhysical Therapy
Vol/bind96
Udgave nummer6
Sider (fra-til)787-796
ISSN0031-9023
DOI
StatusUdgivet - 2016

Fingeraftryk

Shoulder Impingement Syndrome
Randomized Controlled Trials
Exercise
Outcome Assessment (Health Care)
Confidence Intervals
Shoulder Pain
Intention to Treat Analysis
Occupational Medicine
Physical Therapists
Program Evaluation
Denmark
Orthopedics

Citer dette

Christiansen, David Høyrup ; Frost, Poul ; Falla, Deborah ; Haahr, Jens Peder ; Frich, Lars Henrik ; Andrea, Linda Christie ; Svendsen, Susanne Wulff. / Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome : Randomized Controlled Trial. I: Physical Therapy. 2016 ; Bind 96, Nr. 6. s. 787-796.
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title = "Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome: Randomized Controlled Trial",
abstract = "BACKGROUND: Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function.OBJECTIVE: The purpose of this study was to evaluate the effectiveness at 3 and 12 months of a standardized physical therapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery.DESIGN: A multicenter randomized controlled trial was conducted.SETTING: The study was conducted in 6 public departments of orthopedic surgery, 2 departments of occupational medicine, and 2 physical therapy training centers in Central Denmark Region.PATIENTS: One hundred twenty-six patients reporting difficulty returning to usual activities at the postoperative clinical follow-up 8 to 12 weeks after subacromial decompression surgery participated.INTERVENTION: A standardized exercise program consisting of physical therapist-supervised individual training sessions and home training was used.OUTCOME MEASURES: The primary outcome measure was the Oxford Shoulder Score. Secondary outcome measures were the Constant Score and the Fear-Avoidance Beliefs Questionnaire.RESULTS: At 3 and 12 months, follow-up data were obtained for 92{\%} and 83{\%} of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months, with an adjusted mean difference of 2.0 (95{\%} confidence interval=-0.5, 4.6), and at 12 months, with an adjusted mean difference of 5.8 (95{\%} confidence interval=2.8, 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcome measures.LIMITATIONS: The nature of the exercise intervention did not allow blinding of patients and care providers.CONCLUSION: The standardized physical therapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and function at 12 months compared with usual care.",
author = "Christiansen, {David H{\o}yrup} and Poul Frost and Deborah Falla and Haahr, {Jens Peder} and Frich, {Lars Henrik} and Andrea, {Linda Christie} and Svendsen, {Susanne Wulff}",
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Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome : Randomized Controlled Trial. / Christiansen, David Høyrup; Frost, Poul; Falla, Deborah; Haahr, Jens Peder; Frich, Lars Henrik; Andrea, Linda Christie; Svendsen, Susanne Wulff.

I: Physical Therapy, Bind 96, Nr. 6, 2016, s. 787-796.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome

T2 - Randomized Controlled Trial

AU - Christiansen, David Høyrup

AU - Frost, Poul

AU - Falla, Deborah

AU - Haahr, Jens Peder

AU - Frich, Lars Henrik

AU - Andrea, Linda Christie

AU - Svendsen, Susanne Wulff

N1 - © 2016 American Physical Therapy Association.

PY - 2016

Y1 - 2016

N2 - BACKGROUND: Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function.OBJECTIVE: The purpose of this study was to evaluate the effectiveness at 3 and 12 months of a standardized physical therapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery.DESIGN: A multicenter randomized controlled trial was conducted.SETTING: The study was conducted in 6 public departments of orthopedic surgery, 2 departments of occupational medicine, and 2 physical therapy training centers in Central Denmark Region.PATIENTS: One hundred twenty-six patients reporting difficulty returning to usual activities at the postoperative clinical follow-up 8 to 12 weeks after subacromial decompression surgery participated.INTERVENTION: A standardized exercise program consisting of physical therapist-supervised individual training sessions and home training was used.OUTCOME MEASURES: The primary outcome measure was the Oxford Shoulder Score. Secondary outcome measures were the Constant Score and the Fear-Avoidance Beliefs Questionnaire.RESULTS: At 3 and 12 months, follow-up data were obtained for 92% and 83% of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months, with an adjusted mean difference of 2.0 (95% confidence interval=-0.5, 4.6), and at 12 months, with an adjusted mean difference of 5.8 (95% confidence interval=2.8, 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcome measures.LIMITATIONS: The nature of the exercise intervention did not allow blinding of patients and care providers.CONCLUSION: The standardized physical therapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and function at 12 months compared with usual care.

AB - BACKGROUND: Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function.OBJECTIVE: The purpose of this study was to evaluate the effectiveness at 3 and 12 months of a standardized physical therapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery.DESIGN: A multicenter randomized controlled trial was conducted.SETTING: The study was conducted in 6 public departments of orthopedic surgery, 2 departments of occupational medicine, and 2 physical therapy training centers in Central Denmark Region.PATIENTS: One hundred twenty-six patients reporting difficulty returning to usual activities at the postoperative clinical follow-up 8 to 12 weeks after subacromial decompression surgery participated.INTERVENTION: A standardized exercise program consisting of physical therapist-supervised individual training sessions and home training was used.OUTCOME MEASURES: The primary outcome measure was the Oxford Shoulder Score. Secondary outcome measures were the Constant Score and the Fear-Avoidance Beliefs Questionnaire.RESULTS: At 3 and 12 months, follow-up data were obtained for 92% and 83% of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months, with an adjusted mean difference of 2.0 (95% confidence interval=-0.5, 4.6), and at 12 months, with an adjusted mean difference of 5.8 (95% confidence interval=2.8, 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcome measures.LIMITATIONS: The nature of the exercise intervention did not allow blinding of patients and care providers.CONCLUSION: The standardized physical therapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and function at 12 months compared with usual care.

U2 - 10.2522/ptj.20150652

DO - 10.2522/ptj.20150652

M3 - Journal article

C2 - 26916927

VL - 96

SP - 787

EP - 796

JO - Physical Therapy

JF - Physical Therapy

SN - 0031-9023

IS - 6

ER -