No Need for Subacromial Decompression in Responders to Specific Exercise Treatment - A 10-year follow-up of a Randomized Clinical Trial.

Background: Subacromial pain is a common and disabling condition with multifactorial aetiology. Increasing evidence supports exercises as first-line treatment and need of surgery is debated. Long-term follow-ups after surgical- and non-surgical treatment are scarce.

The minimal important change for the seven-item disability of the arm, shoulder, and hand (DASH 7) questionnaire - Assessing shoulder function in patients with subacromial pain.

Background: The DASH 7 is a recently published activity-related 7-item short form of the disability of the arm, shoulder, and hand (DASH) questionnaire developed to assess shoulder function in patients with subacromial pain. Before implementation in both intervention studies and in clinical practice, it is essential to evaluate its responsiveness. The objective of this study was to determine the minimal important change (MIC) in the DASH 7 questionnaire for patients with subacromial pain after a 3 months exercise intervention in a primary care context.

Heterogeneity among patients with subacromial pain - variabilities within clinical presentation and its impact on daily life.

Objective: The primary aim was to describe the variability within clinical presentation of patients with subacromial pain in primary care, secondly to investigate associations between clinical presentation and self-reported pain intensity, shoulder function, level of anxiety and depression, and health-related quality of life.

Design And Setting: A cross-sectional study based on data from two clinical studies in primary care, one randomized controlled trial and one implementation study. Three components: active range of motion (AROM), rotator cuff function and scapular kinematics were analyzed to describe variability within clinical presentation and patient-reported measurements were used to investigate the impact on daily life.

Good outcome after repair of trauma-related anterosuperior rotator cuff tears-a prospective cohort study.

Background: Anterosuperior rotator cuff tears with a displaced long head of the biceps tendon are most often trauma-related, and patients with these conditions often present with severe pain and shoulder dysfunction. Repair of the subscapularis and supraspinatus and a biceps tenodesis or a tenotomy are the recommended treatments based on retrospective studies. The aim of this study was to prospectively evaluate clinical and structural treatment outcome in a cohort of trauma-related anterosuperior injuries in patients with previously healthy shoulders.

Surgery and physiotherapy were both successful in the treatment of small, acute, traumatic rotator cuff tears: a prospective randomized trial.

Background: Previous randomized trials on cuff repair have included mainly degenerative tears, but studies on acute traumatic tears are lacking. We aimed to compare early surgical repair with nonoperative treatment for traumatic supraspinatus tears.

Methods: We did a 2-center randomized controlled trial of patients with small rotator cuff tears mainly involving supraspinatus, comparing surgical repair (n = 32) and physiotherapy (n = 26).

Practitioner experiences from the structured implementation of evidence-based practice in primary care physiotherapy: A qualitative study.

Rationale, Aims, And Objectives: To provide best available care, the practitioners in primary health care (PHC) must have adequate knowledge about effective interventions. The implementation of such interventions is challenging. A structured implementation strategy developed by researchers at Linköping University, Sweden, was used for the implementation of an evidence-based assessment and treatment programme for patients with subacromial pain among physiotherapists in PHC.

Specific exercises for subacromial pain.

Background and purpose - We have previously shown that specific exercises reduced the need for surgery in subacromial pain patients at 1-year follow-up. We have now investigated whether this result was maintained after 5 years and compared the outcomes of surgery and non-surgical treatment. Patients and methods - 97 patients were included in the previously reported randomized study of patients on a waiting list for surgery.

A short activity-related scale for measuring shoulder function in patients with subacromial pain: the DASH 7.

Background: Subacromial pain is a common cause of shoulder dysfunction that negatively affects quality of life. Currently, most outcome measures for shoulder pain are applied to a heterogeneous group of patients. Of these measures, the Disabilities of the Arm, Shoulder, and Hand (DASH) is the most widely recognized test with which to assess patients with subacromial pain.

Consensus for physiotherapy for shoulder pain.

Purpose: Shoulder pain is a common disorder. Despite growing evidence of the importance of physiotherapy, in particular active exercise therapy, little data is available to guide treatment. The aim of this project was to contribute to the development of an internationally accepted assessment and treatment algorithm for patients with shoulder pain.

Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study.

Study Question: Can a specific exercise strategy improve shoulder function and pain in patients with subacromial impingement syndrome, thereby decreasing the need for arthroscopic subacromial decompression?

Summary Answer: Compared with a control exercise group, patients in the specific exercise group had significantly greater improvements in shoulder function and pain and fewer patients needed surgery at the three month assessment.

What Is Known And What This Paper Adds: Different exercise programmes are used as first line treatment in patients with subacromial impingement syndrome, but conclusive evidence to support the efficacy for these programmes is lacking. This specific exercise strategy proved effective in improving shoulder function and pain in patients in whom earlier conservative treatment had failed.

A specific exercise strategy reduced the need for surgery in subacromial pain patients.

Background And Purpose: A programme based on eccentric exercises for treating subacromial pain was in a previous study found effective at 3-month follow-up. The purposes of the present study were to investigate whether the results were maintained after 1 year and whether the baseline Constant-Murley score, rotator cuff status and radiological findings influenced the outcome.

Patients And Methods: 97 patients on the waiting list for arthroscopic subacromial decompression had been randomised to a specific exercise programme or unspecific exercises (controls).

Minimal important changes in the Constant-Murley score in patients with subacromial pain.

Objective: The purpose of this study was to determine the minimal important change (MIC) of improvement in the Constant-Murley score in patients with long-standing subacromial pain and in subgroups of patients with subacromial pain with and without rotator cuff ruptures.

Method: The MIC was estimated by the anchor-based MIC distribution method, which integrates an anchor- and distribution-based approach: the optimal cutoff point of the receiver operating characteristic curve (MICROC) and the 95% limit cutoff point (MIC95% limit). The study population consisted of 93 patients included in a randomized clinical trial evaluating the effect of a specific exercise strategy.

Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study.

Objective: To evaluate if a specific exercise strategy, targeting the rotator cuff and scapula stabilisers, improves shoulder function and pain more than unspecific exercises in patients with subacromial impingement syndrome, thereby decreasing the need for arthroscopic subacromial decompression.

Design: Randomised, participant and single assessor blinded, controlled study.

Setting: Department of orthopaedics in a Swedish university hospital.

Supervised strengthening exercises versus home-based movement exercises after arthroscopic acromioplasty: a randomized clinical trial.

Objective: To evaluate and compare the efficacy of 2 rehabilitation strategies after arthroscopic acromioplasty: supervised physical therapy focusing on strengthening exercises of the rotator cuff and scapula stabilizers (PT-group) vs home-based movement exercises (H-group).

Design: A randomized, single-blinded, clinically controlled study.

Patients: Thirty-six patients entered the study.