Ann Rehabil Med.  2023 Feb;47(1):26-35. 10.5535/arm.22150.

Eccentric Versus Concentric Exercises in Patients With Rheumatoid Arthritis and Rotator Cuff Tendinopathy: A Randomized Comparative Study

• Wahba MM
• Selim M
• Hegazy MM
• Elgohary R
• Abdelsalam MS

• KMID: 2539725
• DOI: http://doi.org/10.5535/arm.22150

Abstract

Objective
To determine the efficacy of concentric vs. eccentric exercise in improving shoulder function, pain, and tendon characteristics for patients with rheumatoid arthritis and rotator cuff tendinopathy.
Methods
Forty patients with rheumatoid arthritis and rotator cuff tendinopathy were divided into either concentric or eccentric exercise groups, with 20 patients in each group. Patients received 12 sessions at a pace of 3 sessions per week. Shoulder Pain and Disability Index (SPADI), the visual analogue scale (VAS), supraspinatus and subscapularis thickness, echo pixels, and the Disease Activity Score-28-erythrocyte sedimentation rate (DAS-28-ESR) were assessed at baseline and post-treatment.
Results
There was a significant difference between the concentric and eccentric groups regarding SPADI and VAS scores in favor of the eccentric group. However, there was no significant difference between the two groups regarding tendon thickness, echo pixels, or DAS-28-ESR.
Conclusion
Eccentric exercises were more effective than concentric exercises in improving shoulder function and pain intensity. However, neither of the two types of exercises was superior in improving tendon characteristics or disease activity.

Keyword

Rheumatoid arthritis; Exercise; Rotator cuff; Tendinopathy; Shoulder pain

Figure

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  Fig. 1. Study flowchart.

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  Fig. 2. Internal and external rotation exercise (A) starting position for external rotation, (B) end position of external rotation, (C) starting position for internal rotation, and (D) end position of internal rotation.

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  Fig. 3. Abductor strengthening (A) starting position for abduction and (B) end position of abduction.

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