The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
권호 표지

Effect of Motor Control Training with Strengthening Exercises on Pain and Muscle Strength of Patients with Shoulder Impingement Syndrome

  • Bae, Youn-Hee (Department of Physical Therapy, Graduate school of SahmYook University) ;
  • Lee, Gyu-Chang (Department of Physical Therapy, Kyungnam University)
  • Received : 2011.10.01
  • Accepted : 2011.11.28
  • Published : 2011.12.26
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to investigate the effect of movement training based on motor control theory on pain and average power of muscles in patients with shoulder impingement syndrome and to develop more effective training methods. Methods: We studied 35 patients with shoulder impingement syndrome. Patients were randomly assigned to an experimental group or a control group according to the intervention. The therapeutic modalities such as superficial heat, deep heat, and electronic stimulus, and motor control training with strengthening exercises were applied to the experimental group and therapeutic modalities only were applied to the control group. All interventions were done 3 times a week for 4 weeks. Before the intervention and again after the 4 weeks, we measured pain utilizing a visual analog scale. We measured average power using isokinetic equipment. Results: After application of the intervention, pain significantly decreased in both the experimental group and the control group. There was a significant difference between the extent of the decrease between experimental and control groups. After the intervention, the average power between the two groups were significant at an angle of $60^{\circ}$/sec and $180^{\circ}$/sec for external rotator and internal rotator muscles. They also showed significant improvement in all variables post-intervention compared to pre-intervention. Conclusion: This study indicates that there is an effect in giving appropriate motor control training to patients with shoulder impingement syndrome. It is assumed that there will be a need for more surveys on various variables for motor control training from now on.

Keywords

References

  1. Michener LA, Walsworth MK, Burnet EN. Effectiveness of rehabilitation for patients with ubacromial impingement syndrome: a systematic review. J Hand Ther. 2004;17(2) :152-164. https://doi.org/10.1197/j.jht.2004.02.004
  2. Senbursa G, Baltaci G, Atay A. Comparison of conservative treatment with and without manual physical therapy for patients with shoulder impingement syndrome: a prospective, randomized clinical trial. Knee Surg Sports Traumatol Arthrosc. 2007;15(7):915-921. https://doi.org/10.1007/s00167-007-0288-x
  3. Jang KH, Choi JD, Lee MH, Kim CY. A Comparison of Modified Sling Exercise and General Isometric Exercise in Patients with Shoulder Impingement Syndrome. J Kor Soc Phys Ther. 2010;22(5):9-16.
  4. Matsen FA, Arntz. CT: Subacromial impingement. In the shoulder. Philaldelphia, WA Saunders Co., 1990:623-646.
  5. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80(3):276-291.
  6. Lombardi I, Jr., Magri AG, Fleury AM, Da Silva AC, Natour J. Progressive resistance training in patients with shoulder impingement syndrome: a randomized controlled trial. Arthritis Rheum. 2008;59(5):615-622. https://doi.org/10.1002/art.23576
  7. Roy JS, Moffet H, McFadyen BJ. Upper limb motor strategies in persons with and without shoulder impingement syndrome across different speeds of movement. Clin Biomech. 2008; 23(10):1227-1236. https://doi.org/10.1016/j.clinbiomech.2008.07.009
  8. Deutsch A, Altchek DW, Schwartz E et al. Radiologic measurement of superior displacement of the humeral head in the impingement syndrome. J Shoulder Elbow Surg. 1996; 5(3):186-193. https://doi.org/10.1016/S1058-2746(05)80004-7
  9. Moffet H, Hebert LJ, Dufour M et al. Variation in sub-acromial distance measured by magnetic resonance imaging during shoulder flexion and abduction movements. Can J Rehabil. 1998;11:265-267.
  10. Myers JB, Wassinger CA, Lephart SM. Sensorimotor contribution to shoulder stability: effect of injury and rehabilitation. Man Ther. 2006;11(3):197-201. https://doi.org/10.1016/j.math.2006.04.002
  11. Wadsworth DJ, Bullock-Saxton JE. Recruitment patterns of the scapular rotator muscles in freestyle swimmers with subacromial impingement. Int J Sports Med. 1997;18(8): 618-624. https://doi.org/10.1055/s-2007-972692
  12. Reddy AS, Mohr KJ, Pink MM et al. Electromyographic analysis of the deltoid and rotator cuff muscles in persons with subacromial impingement. J Shoulder Elbow Surg. 2000; 9(6):519-523. https://doi.org/10.1067/mse.2000.109410
  13. Winstein CJ, Campbell-Stewart J. Conditions of tasks practice for individuals with neurologic impairments. In Textbook of Neural Repair and Rehabilitation. Medical Neurorehabilitation Volume II. New York, Cambridge University Press, 2006;89-102.
  14. Salmoni AW, Schmidt RA, Walter CB. Knowledge of results and motor learning: a review and critical reappraisal. Psychol Bull. 1984;95(3):355-386.
  15. Schmidt RA, Lee TD. Motor Control and Learning: a behavioral emphasis Champaign, Ill: Human Kinetics. 2005.
  16. Roy JS, Moffet H, Hebert LJ et al. Effect of motor control and strengthening exercises on shoulder function in persons with impingement syndrome: a single-subject study design. Man Ther. 2009;14(2):180-188. https://doi.org/10.1016/j.math.2008.01.010
  17. On AY, Uludag B, Taskiran E, Ertekin C. Differential corticomotor control of a muscle adjacent to a painful joint. Neurorehabil Neural Repair. 2004;18(3):127-133. https://doi.org/10.1177/0888439004269030
  18. Flor H. Cortical reorganisation and chronic pain: implications for rehabilitation. J Rehabil Med. 2003;(41 Suppl):66-72.
  19. van Vliet PM, Heneghan NR. Motor control and the management of musculoskeletal dysfunction. Man Ther. 2006;11(3):208-213. https://doi.org/10.1016/j.math.2006.03.009
  20. Hodges PW. Changes in motor planning of feedforward postural responses of the trunk muscles in low back pain. Exp Brain Res. 2001;141(2):261-266. https://doi.org/10.1007/s002210100873
  21. Park MC, Bae SS, Lee MY. Change of activation of the supplementary motor area in motor learning: an fMRI case study. J Kor Soc Phys Ther. 2011;23(2):85-90.
  22. Kwon YH, Chang JS, Kim CS. Changes of Cortical Activation Pattern Induced by Motor Learning with Serial Reaction Time Task. J Kor Soc Phys Ther. 2009;21(1):65-72. https://doi.org/10.1589/jpts.21.65
  23. Tyc F, Boyadjian A, Devanne H. Motor cortex plasticity induced by extensive training revealed by transcranial magnetic stimulation in human. Eur J Neurosci. 2005;21(1):259-266. https://doi.org/10.1111/j.1460-9568.2004.03835.x
  24. Tsao H, Hodges PW. Immediate changes in feedforward postural adjustments following voluntary motor training. Exp Brain Res. 2007;181(4):537-546. https://doi.org/10.1007/s00221-007-0950-z
  25. Cowan SM, Bennell KL, Hodges PW et al. Simultaneous feedforward recruitment of the vasti in untrained postural tasks can be restored by physical therapy. J Orthop Res. 2003; 21(3):553-558. https://doi.org/10.1016/S0736-0266(02)00191-2
  26. Keele KD. The pain chart. Lancet. 1948;2:6-8.
  27. Leroux J-.L, Codine P, Thomas E, et al. Isokinetic evaluation of rotational strength in normal shoulders and shoulders with impingement syndrome. Clin Orthop. 1994;(304):108-115.
  28. Lombardi I, Jr., Magri AG, Fleury AM et al. Progressive resistance training in patients with shoulder impingement syndrome: a randomized controlled trial. Arthritis Rheum. 2008;59(5):615-622. https://doi.org/10.1002/art.23576
  29. McClure PW, Bialker J, Neff N et al. Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program. Phys Ther. 2004;84(9):832-848.
  30. Fitts PM, Posner MI. Human Performance Belmont. CA: Brooks Cole. 1967.