The effect of home-exercise with and without additional osteopathic treatment for those with shoulder impingement syndrome

Abstract

The aim of this prospective case series was to document the outcome of a home-exercise program used alone and combined with a semi-standardised osteopathic treatment plan for those with shoulder impingement syndrome. Six participants with shoulder impingement were randomised into either a home-exercise group (n=3) or osteopathic group (n=3) and were followed during the ten week study period. All participants completed a 6-week home-exercise program aimed at centering the humeral head within the glenoid fossa and received 6 supervised training sessions. In addition, participants in the osteopathic group received 6 osteopathic treatments. Shoulder pain and function was measured using the Shoulder Pain and Disability Index (SPADI), Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure, and the Numeric Pain Rating Scale (NPRS) during physical examination of the shoulder. Outcome measures were taken at three baseline measurements, after the final intervention, and at a 2-week follow-up session. Clinically meaningful change was defined as a pre-post reduction greater than the minimal clinically important difference (MCID) for each respective outcome measure. All participants demonstrated clinically meaningful change for the SPADI, DASH, and NPRS for both the Neer and Hawkins impingement tests at post-intervention and 2-week follow-up. Clinically meaningful change was demonstrated at the 2-week follow-up for five participants for the painful arc test, five participants for the empty can test, one participant for the active-resisted internal rotation test, and four participants for the active-resisted external rotation test. The results of this study suggest that a home-exercise program with the aim of centering the humeral head within the glenoid fossa is associated with clinically meaningful improvements in shoulder pain and function when used alone and in conjunction with osteopathic treatment.