Article

Shoulder pain resulting from subacromial impingement syndrome (SAIS)
is a common problem with a relatively poor response to treatment. There is little
research exploring physical therapists' perspectives on the management of the
syndrome. OBJECTIVES: The study objective was to investigate physical therapists'
perceptions and experiences regarding the use of exercise in the treatment of
patients with SAIS. DESIGN:
This was a qualitative focus group study. METHODS:
Three 60- to 90-minute focus group sessions containing 6 to 8 experienced
musculoskeletal physical therapists (total number=20) were conducted. Thematic
content analysis was used to analyze transcripts and develop core themes and
categories. RESULTS: Exercise was seen as key in the management of SAIS. The
overarching theme was the need to "gain buy-in to exercise" at an early stage.
The main subtheme was patient education. Therapists identified the need to use
education about SAIS etiology to foster buy-in and "sell" self-management through
exercise to the patient. They consistently mentioned achieving education and
buy-in using visual tools, postural advice, and sometimes a "quick fix" of pain
control. Furthermore, experienced practitioners reported including educational
interventions much earlier in treatment than when they first qualified.
Therapists emphasized the need for individually tailored exercises, including:
scapular stabilization; rotator cuff, lower trapezius, and serratus anterior
muscle strengthening; and anterior shoulder and pectoralis minor muscle
stretching. Quality of exercise performance was deemed more important than the
number of repetitions that the patients performed. LIMITATIONS: Expanding the
geographical area over which the focus groups were conducted and including
therapists with less than 5 years of postgraduate experience may have
strengthened the findings of this study. CONCLUSION: Experienced musculoskeletal
physical therapists believe that exercise is central in treating patients with
SAIS and that gaining patient buy-in to its importance, patient education,
promoting self-management, and postural advice are central to the successful
treatment of people with SAIS.
CI - (c) 2016 American Physical Therapy Association.

Langue : ANGLAIS