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Shoulder exercise regime ‘prevents surgery’

A targeted exercise strategy improves shoulder function and reduces the number of patients subacromial impingement going on to have surgery, finds a Swedish study.

The study compared specific strengthening exercises versus unspecific movement for the neck and shoulder in a group of 198 patients with long-term subacromial impingement that had not responded to earlier treatment.

Patients were instructed to do the exercises in classes and at home, with those in the specific exercise group performing eccentric exercises for the rotator cuff and concentric and eccentric exercises for the scapula stabiliser muscles.

Those in the specific exercise group reported a mean change in the Constant-Murley shoulder assessment score of 25, compared with a mean change of nine in the control group of 46 patients.

After 12 weeks, 69% of those in the specific exercise group reported a large improvement or recovery compared with 24% in the control group. Only 20% of the specific exercise group subsequently chose to have surgery, compared with 63% of the control group.

Study author Dr Kajsa Johansson, senior lecturer in physiotherapy at Linköping University, Sweden said that the research ‘adds valuable knowledge for managing patients with persistent subacromial impingement syndrome.'

BMJ 2012, published online 20 February

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