Self-training versus conventional physiotherapy in subacromial impingement syndrome

Aim: This prospective, randomized study was aimed to compare the effect of a standardized self-training versus standard physiotherapist-supervised exercises in the non-operative treatment of shoulder impingement syndrome types Neer I and II. Method: 40 patients with subacromial impingement I/II were randomized to two groups. Group 1 performed a mostly isometric self-training after instruction by a physiotherapist, group 2 recieved prescriptions for physiotherapy and strengthening exercises for the rotator cuff. Follow up was performed after 6 and 12 weeks with the use of the constant score (unpondered). Patient satisfaction with the treatment was controlled by VAS (1 - 6). Result: After 12 weeks, patients of group 1 had performed the exercises 5 x/week for 15 minutes. Patients of group 2 had received 30 sessions in average. Patients of group 1 improved from a mean of 59 points (39.5 - 86) to a mean of 68 points (37 - 88) after 6 and 75 points (65 - 90) after 12 weeks. Patients of group 2 improved from 60.5 points (41 - 83) to 67 points (39.5 - 92) and 72 points (43 - 93), respectively. Patient satisfaction was higher in the self-training group (1.9 : 2.8). Conclusion: Strengthening of the centering muscles around the humeral head leads to good results in the non-operative treatment of subacromial impingement. Self-training after instruction showed no difference to physiotherapist-supervised exercises in the non-operative treatment of subacromial impingement.