Korean J Sports Med.  2018 Mar;36(1):34-44. 10.5763/kjsm.2018.36.1.34.

Effect of a Specific Rehabilitation Program of Serratus Anterior and Lower Trapezius Muscles for Subacromial Impingement Syndrome on Subacromial Space and the Vascularity of Supraspinatus Tendon

• Kim E
• Choi H

• KMID: 2465227
• DOI: http://doi.org/10.5763/kjsm.2018.36.1.34

Abstract

PURPOSE
This study was designed to assess the effects of a rehabilitation program on clinical symptoms, subacromial space parameters and the supraspinatus vascularity in individuals with subacromial impingement syndrome (SIS).
METHODS
Thirty-five participants (exercise group with SIS [EG]=11, non-exercise group with SIS [NEG]=10, control group [CG]=14) took part in this study. Only EG participated in 6-week rehabilitation program. Outcomes were evaluated at baseline, 6 weeks, and 10 weeks. Changes in symptoms and functional limitations were assessed using Shoulder Pain and Disability Index (SPADI) questionnaire. Changes in acromiohumeral distance (AHD) and supraspinatus tendon thickness (STT)/AHD were assessed using ultrasonographic measures. Quantitative analysis of tendon blood flow was performed by determining four regions of interest with power Doppler quantification and analysis software to normalize data for interpretation of the mean ratio of colored pixel to the region of interest (vascularization index [VI]) and the intensity per pixel (flow index [FI]).
RESULTS
Following the rehabilitation program, the scores on SPADI were significantly improved (p < 0.05). However, AHD, STT/AHD, VI, and FI indicated no significant difference within groups or interactions of time and group in between groups.
CONCLUSION
The rehabilitation program yielded improvements in symptoms, but not in subacromial parameters and the vascularity of supraspinatus in participants with SIS.

Keyword

Acromiohumeral distance; Power Doppler; Subacromial impingement syndrome; Supraspinatus tendon thickness; Ultrasonography

MeSH Terms

Rehabilitation*
Shoulder Impingement Syndrome*
Shoulder Pain
Superficial Back Muscles*
Tendons*
Ultrasonography

Figure

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  Fig. 1 Measurement of supraspinatus tendon.

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  Fig. 2 Measurement of acromiohumeral distance (A) and position (B).

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  Fig. 3 QLAB analysis of power Doppler ultrasound of supraspinatus tendon.

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  Fig. 4 Rehabilitation program. (A) Robbery exercise for lower trapezius. (B) Lawn mower exercise for lower trapezius. (C) Low exercise for lower trapezius. (D) Inferior glide exercise for lower trapezius. (E) Prone shoulder flexion at 135° abduction for lower trapezius. (F) Push-ups with a plus for serratus anterior.

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