• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.19-25
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• 1998

Appropriate clinical examination and imaging may lead to early diagnosis and treatment of the shoulder impingement syndrome, thus preventing progressing to a complete tear of rotator cuff. The impingement syndrome was caused by repeated entrapment and compression of supraspinatus tendon between the proximal end of humerus inferiorly, particullary its greater tuberosity. and one or m <)re component of coracoacromial arch superiorly. The purpose of this study is to critically, evaluate the result of twenty-five consecutive subacromial decompression with impingement syndrome and to assess the diagnostic accuracy of MR imaging by using oblique coronal and oblique sagittal plan. These patients were treated by arthroscopic subacromial decompression after their pains failed to improve with conservative therapy over three month. The average follow up was 25 month(range, 12 to 50). The mean age was 43 year old. The results were rated based on subjective response and the UCLA shoulder rating scale of the result. Ten patients(40%) were rated as excellent, 11patients(44%) were good. while four patients(16%) were fair. Radiologic evaluation suggested that the oblique sagittal plan of MRI can be helpful in evaluation of bony and soft-tissue structure of the coracoacromial arch and determining depth of bony resection. There were no infection or neurovascular injury. In reviewing our result, it appears that the arthroscopic subacromial decompression can be successful sugery for shoulder impingement syndrome and diagnostic accuracy of supplimentary oblique sagittal view of MRI was relatively higher than oblique coronal view alone for apprqpriate surgical plan.

• International Journal of Advanced Culture Technology
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• v.12 no.2
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• pp.90-97
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• 2024

Shoulder impingement syndrome (SIS) is a common musculoskeletal condition characterized by pain and functional limitation due to the impingement of subacromial structures. This comprehensive review elucidates the complex nature of SIS, covering its pathophysiology, diagnostic methodologies, treatment options, and preventive measures. Through an exhaustive examination of current literature and clinical practices, the review highlights the importance of a multifaceted approach to SIS management. Physical therapy plays a pivotal role, focusing on exercises to strengthen shoulder musculature, enhance scapular stability, and improve range of motion. The review also discusses the strategic use of medications such as NSAIDs and corticosteroid injections, emphasizing their effectiveness in pain and inflammation management. Additionally, it advocates for structured rehabilitation programs post-treatment to restore function and prevent recurrence, recommending preventive strategies like ergonomic adjustments, targeted exercises, and proper technique training. This paper underscores the need for personalized and evidence-based treatment strategies, integrating physical therapy and pharmacological management when necessary.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.390-396
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• 2023

Background: The subacromial (SA) space is a commonly used injection site for treatment of impingement syndrome. For shoulder stiffness, glenohumeral (GH) injections are commonly performed. However, in cases of impingement syndrome with mild shoulder stiffness, the optimal site of steroid injection has yet to be identified. Methods: This prospective, randomized study compared the short-term outcomes of ultrasound-guided GH and SA steroid injections in patients who were diagnosed with impingement syndrome and mild stiffness. Each group comprised 24 patients who received either a GH or SA injection of 40 mg of triamcinolone. Range of motion and clinical scores were assessed before and 3, 7, and 13 weeks after the injection. Results: GH and SA injections significantly improved the range of motion and clinical scores after 13 weeks of follow-up. Notably, targeting the GH joint resulted in an earlier gain of forward elevation, external rotation, and internal rotation in 3 weeks (P<0.001, P=0.012, and P=0.002, respectively) and of internal rotation and a Constant-Murley score in 7 weeks (P<0.001 and P=0.046). Subsequent measurements were similar between the groups and showed a steady improvement in all ranges of motion and clinical scores. Conclusions: GH injections may be more favorable than SA injections for treatment of impingement syndrome with mild stiffness, especially in improving the range of motion in the early period. However, the procedures showed similar outcomes after 3 months. Level of evidence: I.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.3
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• pp.341-351
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• 2011

Purpose : The purpose of this study was to determine the initial effects of deltoid inhibition taping to Pain, Function, Strength, ROM in shoulder impingement syndrome (SIS). Methods : This study is 28 patients(male 16, female 12) with shoulder impingement syndrome(SIS).The experimental group received deltoid inhibition taping and the control group had sham taping. Outcome variables measured degree of pain, disability, strength, and range of motion at pre-post intervention. The changes between pre-post interventions are analyzed by a repeated measure ANOVA test. Results : Pain and disability index significantly decreased (p<.05), and the rate of change in pain and disability level of the experimental group increased significantly more than control group (p<.05). Strength and range of motion significantly increased (p<.05), but the rate of change of the two groups showed no significant difference (p>.05). Conclusion : These results suggest that deltoid inhibition taping was initial effective in decreasing pain and disability in SIS patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.4
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• pp.914-918
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• 2009

Recently, according to increasing population to enjoy sports, Shoulder Impingement Syndrome occurred frequently. In this report, we introduce a case suffered from chronic shoulder pain, ROM restriction because of Shoulder Impingement Syndrome treated by Sweet BV acupuncture. Sweet BV acupuncture maintains the BV acupuncture effects and restricts allergic reaction at the same time. In this report, Sweet BV acupuncture is a new therapy that have a safety and efficiency simultaneously.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.553-564
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• 2022

Objective: The purpose of this studyaimed to investigate the effects of scapular stabilization training using the different exercise prop for impingement syndrome of factory workers. Design: A randomized controlled trial Methods: Twenty shoulder impingement syndrome subjects were randomly divided into two groups of ten subjects each. Inclusion criteria was presence of positive sign in at least two of Neer test, Hawkins test, Yocum test, Jobe test and Speeds test. Andexclusion criteria, those with surgical history of rotator cuff, those with disease in upper limb other than shoulder impingement syndrome, those who took anti-inflammatory drugs over the past 12 months were excluded from the sample. One group was performed scapula stabilization exercise using elastic bands, while dumbbell group performed the exercise using dumbbell. Both groups performed the exercise after applying the general physical therapy. After applying five days a week for a total of six weeks, range of motion of shoulder joint, muscle strength and pain and function level were evaluated. Results: After the intervention, in both groups, all dependent variables at the 6-week post-test significantly improved compared with the pre-test (p<0.05). In addition, elastic band exercise group showed a significant differences in SPADI function score and SPADI total score compared to the dumbbell group(p<0.05). Conclusions: The elastic band training may be effective methodology using low-to-moderate intensity resistance for SPADI scores.

• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.45-50
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• 2004

Purpose: The purpose of this study is to compare the outcome of operative results in the impingement syndrome of the shoulder with and without the stiffness. Material and Method: Seventy-six patients who had the impingement syndrome without stiffness were evaluated, and treated with the subacromial decompression and 24 patients who had the impingement syndrome with stiffness, were treated with the subacromial decompression and the manipulation. The average follow-up period was 32 months. Result: The impingement syndrome of the shoulder with stiffness was more severe in the preoperative pain and worse in ASES score than without stiffness. The postoperative pain and ASES score improved in the both group. The satisfactory groups were 67% in the group with stiffness and 80% without stiffness. The satisfactory rate was 83% in the group with stiffness and 93% without stiffness. The satisfactory groups with diabetes were 47% in the group with stiffness and 81% without stiffness. Forward elevation, exeternal rotation at the side and internal rotation improved in both groups postoperatively and there were no statistically significant differences postoperatively External rotation was restricted statistically in the group with stiffness. Conclusion: Although patients may not regain the full range of motion, the technique of manipulation followed by arthroscopic subacromial decompression offers good pain relief and satisfactory functional recovery for the impingement syndrome with stiffness. However preoperative counseling is necessary for the impingement syndrome combined with diabetes and stiffness due to poor out come.

• Journal of Korean Medicine Rehabilitation
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• v.34 no.1
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• pp.83-95
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• 2024

Objectives This review was conducted to evaluate the therapeutic effects of manual acupuncture (MA) for shoulder impingement syndrome (SIS). Methods We searched 12 electronic databases (DBpia, Korean studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], China National Knowledge Infrastructure [CNKI], CINAHL, Clinical Key, Cochrane Library, Embase, JAMA, PubMed, Web of Science) to find randomized-controlled clinical trials (RCTs) investigating therapeutic effects of MA for treating SIS. Shoulder Pain and Disability Index scores and numeric pain rating scale or visual analogue scale were analyzed as the main evaluation criteria. Results Among 181 studies, 169 were screened and only 12 RCTs were eligible in our review. Finally, 11 RCTs could be statistically analyzed. MA was more effective than sham treatment and physical therapy in terms of reducing pain (p=0.003, p=0.0007 each). Electroacupuncture (EA) showed more significant effect than physical therapy (PT) for improving shoulder pain (p<0.00001) and shoulder functionality (p<0.00001). Conclusions These results suggest that MA and EA could be superior option for treating SIS than sham treatment or PT. However this review has its limitations due to the small sample size and lack of well-designed RCTs that were included in the study. Further well-designed RCTs are necessary to provide high-level evidence.

• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.49-53
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• 2000

Purpose : The purpose of this study was to evaluate clinical efficacy of the arthroscopic anterior acromioplasty for the treatment of chronic impingement syndrome of the shoulder. Materials and Methods : Between July 1995 and December 1997, twenty seven consecutive shoulders of 26 patients with chronic impingement syndrome of the shoulder were treated by arthroscopic anterior acromioplasty. The patients who had severe osteoarthritis of the shoulder full thickness tear of the rotator cuff, and nonoutlet impingement were excluded. The clinical results were evaluated by using UCLA shoulder rating scale. The average follow-up was 2years 3months(range, 1year 7months to 3years 1 11months). Results : Twenty three patients$(85.2\%)$ were rated as excellent or good results, while four patients$(14.8\%)$ were fair. Twenty six cases$(96.3\%)$ were satisfied with the results of the operations, while one case$(3.7\%)$, who had Parkinsonian syndrome, ossification of posterior longitudinal ligament(OPLL) of the cervical spine, and spinal stenosis of the 5th and 6th cervical spine was not satisfied. Conclusion : Arthroscopic anterior acromioplasty was an effective treatment method, especially for relief of pain, for the treatment of chronic impingement syndrome of the shoulder. If the patient has the combined lesions in the cervical spine and the shoulder, and systemic lesions, these lesions may influence the results of treatment after operation, and cause the unpredictable results.

• Physical Therapy Korea
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• v.27 no.1
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• pp.38-44
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• 2020

Background: Posterior shoulder tightness, which is a problem mainly seen in patients with shoulder impingement syndrome, disrupts the scapulohumeral rhythm between the humerus and scapulae. Objects: The aim of this study was to compare the effects of joint mobilization and stretching on shoulder muscle activity and internal rotation range of motion (ROM) of the glenohumeral joint in patients with impingement syndrome with posterior shoulder tightness. Methods: The research subjects included 22 in-patients with impingement syndrome with posterior shoulder tightness. They were randomly divided into two groups: one group (12 patients) was treated with joint mobilization and the other group (10 patients) was treated with stretching for the posterior shoulder tightness. Each treatment was performed five times a week for two weeks, and there were 15 sessions for each treatment. The ROM of the internal rotation and muscle activities of shoulder joint were evaluated pretest and posttest in each group. Electromyography data were collected from the upper, middle, and lower trapezius and serratus anterior during shoulder abduction of 90°, 120°, and 150°. Results: Both the joint mobilization and stretching groups showed significant decreases in muscle activity in the upper, middle, and lower trapezius on the posttest (p < 0.05). There was a significant difference in serratus anterior at 150° (p < 0.05), but there was no significant difference between group in post-hoc analysis (p > 0.025). The internal rotation ROM was significantly increased in the stretching group compared to that in the joint mobilization group (p < 0.025). Conclusion: This study found that both joint mobilization and stretching for posterior shoulder tightness were effective in muscle activity during arm abduction, also in order to increase internal rotation ROM of shoulder joint, stretching was effective in patients with impingement syndrome with posterior tightness.