Novel Posterior Shoulder Stretching With Rapid Eccentric Contraction and Static Stretching in Patients With Subacromial Pain Syndrome: A Randomized Trial

Background: In subacromial pain syndrome (SPS), it is unknown whether posterior shoulder stretching exercises (PSSE) with rapid eccentric contraction, a muscle energy technique, improve clinical and ultrasonographic outcomes more than no stretching or static PSSE. Hypothesis: PSSE with rapid eccentric contraction is superior to no stretching and static PSSE in improving clinical and ultrasonographic outcomes in SPS. Study Design: Randomized controlled trial. Methods: Seventy patients with SPS and glenohumeral internal rotation deficit were randomized into the modified cross-body stretching with rapid eccentric contraction group (EMCBS; n = 24), static MCBS group (SMCBS; n = 23), or control group (CG; n = 23). In addition to 4-week physical therapy, EMCBS received PSSE with rapid eccentric contraction, SMCBS static PSSE, and CG no PSSE. The primary outcome was internal rotation range of motion (ROM). Secondary outcomes were posterior shoulder tightness, external rotation ROM (ERROM), pain, modified Constant-Murley score, short form of the disabilities of the arm, shoulder, and hand questionnaire (QuickDASH), rotator cuff strength, acromiohumeral distance (AHD), supraspinatus tendon thickness, and supraspinatus tendon occupation ratio (STOR). Results: Shoulder mobility, pain, function and disability, strength, AHD, and STOR improved in all groups (P < 0.05). Conclusion: In patients with SPS, PSSE with rapid eccentric contraction and static PSSE were superior to no stretching in improving clinical and ultrasonographic outcomes. Stretching with rapid eccentric contraction was not superior to static stretching, but improved ERROM compared with no stretching.

Automated summary

This study compared the effects of posterior shoulder stretching exercises (PSSE) with rapid eccentric contraction, static PSSE, and no stretching on the treatment outcomes of patients with subacromial pain syndrome (SPS). The results showed that PSSE with rapid eccentric contraction was superior to no stretching or static PSSE in improving clinical and ultrasonographic outcomes. Both PSSE with rapid eccentric contraction and static PSSE were effective in improving shoulder mobility, pain, function and disability, strength, acromiohumeral distance (AHD), and supraspinatus tendon occupation ratio (STOR).