Impact of movement training on upper limb motor strategies in persons with shoulder impingement syndrome
Roy JS, Moffet H, McFadyen BJ, Lirette R
Sports Med Arthrosc Rehabil There Technol 2009, 1:8
The goal of this study was to evaluate the short-term effects of supervised, feedback driven training by a physiotherapist, on motor strategies in persons suffering from subacromial impingement syndrome.
The study was conducted on 33 patients and called for an initial visit, during which a DASH questionnaire on disability of the upper limb was given and a training session was conducted with a physiotherapist to demonstrate how to execute a series of movements correctly: reaching objects on different planes in space (frontal, sagittal, transverse). The physiotherapist commented on the patients' performance and corrected it, using techniques such as visual feedback with mirrors, until the proper motor strategy was achieved. The strategy was quantified based on speed of execution, kinematic and electromyographic analysis.
A second visit was held 24 hours later in order to assess the long-term effect of the training.
During, immediately afterward, and 24 hours later, the electromyographic activity of the muscles analyzed proved significantly lower than the basal. From the kinematic point of view, the total range of motion of the trunk and the final position of the trunk, shoulder, and clavicle was improved during and immediately after training, but this value returned to the basal level after 24 hours.
Using correct motor strategies also significantly reduced pain during and immediately after, as well as on the day after exercise.
In conclusion, training integrated with visual, verbal, and tactile feedback from the therapist modifies a patient’s movement strategies and temporarily improves certain aspects of kinematics. In addition, a single session did not prove sufficient to bring about permanent changes to the motor patterns.
This study, despite certain limits tied to the research methodology, demonstrates the potential of motor training in rehabilitation for subacromial impingement syndrome.