Article

OBJECTIVES: To investigate the effect of manual physiotherapy and exercises
compared with exercises alone in patients with shoulder impingement syndrome one
year after inclusion. DESIGN: Randomized controlled trial. SUBJECTS: Patients
with shoulder impingement of more than 4 weeks. METHODS: The intervention group
received individualized manual physiotherapy plus individualized exercises; the
control group received individualized exercises only. Both groups had 10
treatments over 5 weeks; afterwards all patients continued their exercises for
another 7 weeks at home. Primary outcomes were the Shoulder Pain and Disability
Index and Patients' Global Impression of Change. The Generic Patient-Specific
Scale was used as secondary outcome. Costs were recorded in a log-book. RESULTS:
Ninety patients were included in the study and 87 could be analyzed at 1-year
follow-up. Both groups showed significant improvements in all outcome measures,
but no difference was detected between the groups. Only costs differed
significantly in favour of the control group (p = 0.03) after 5 weeks.
CONCLUSION: Individualized exercises resulted in lower costs than manual
physiotherapy and showed a significant effect on pain and functioning within the
whole group after one year. Exercises should therefore be considered as a basic
treatment. Due to the progressive improvement that occurred during the follow-up
period with individualized exercises further treatments should be delayed for 3
to 4 months.

Langue : ANGLAIS