Role of physiotherapy in the treatment of subacromial impingement syndrome: a prospective study

Objective

To investigate the effectiveness of a physiotherapy programme in patients with subacromial impingement syndrome.

Design

Prospective randomised study.

Setting

Orthopaedic department in a district general hospital.

Participants

Eighty-five patients who had been listed for surgery for subacromial impingement syndrome.

Interventions

Patients were allocated at random into one of two groups. One group containing 45 patients received physiotherapy while the other group containing 40 patients acted as controls.

Outcome measures

All patients entering the study underwent Constant score evaluation prior to being allocated to a group. This was repeated at 6 months, prior to surgical intervention.

Results

Seventy-three patients were able to complete the study. In the physiotherapy group, 11 patients no longer required surgery (26%). In this group, all patients improved their Constant score by a mean of 20 (range 4-45). In the control group, all patients required surgery. The mean improvement in the Constant score for the 31 control patients available for review was 0.65 (range −16 to 14).

Conclusion

All patients in this study improved with physiotherapy. Physiotherapy should be thought of as a first-line management for patients with subacromial impingement syndrome.