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

다국어 초록 (Multilingual 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°/sec and 180°/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.

참고문헌 (Reference)

1 박민철, "운동학습에 따른 대뇌 보조운동영역의 활성화 변화: fMRI 사례연구" 대한물리치료학회 23 (23): 85-90, 2011

2 권용현, "시열반응과제의 운동학습이 대뇌피질 활성화의 변화에 미치는 영향" 대한물리치료학회 21 (21): 65-72, 2009

3 장광호, "견관절충돌증후군 환자에 대한 수정된 슬링운동과 일반적 등척성운동의 효과 비교" 대한물리치료학회 22 (22): 9-16, 2010

4 Moffet H, "Variation in sub-acromial distance measured by magnetic resonance imaging during shoulder flexion and abduction movements" 11 : 265-267, 1998

5 Roy JS, "Upper limb motor strategies in persons with and without shoulder impingement syndrome across different speeds of movement" 23 (23): 1227-1236, 2008

6 Keele KD, "The pain chart" 2 : 6-8, 1948

7 Matsen FA, "Subacromial impingement. In the shoulder" WA Saunders Co 623-646, 1990

8 Cowan SM, "Simultaneous feedforward recruitment of the vasti in untrained postural tasks can be restored by physical therapy" 21 (21): 553-558, 2003

9 McClure PW, "Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program" 84 (84): 832-848, 2004

10 Myers JB, "Sensorimotor contribution to shoulder stability: effect of injury and rehabilitation" 11 (11): 197-201, 2006

11 Wadsworth DJ, "Recruitment patterns of the scapular rotator muscles in freestyle swimmers with subacromial impingement" 18 (18): 618-624, 1997

12 Deutsch A, "Radiologic measurement of superior displacement of the humeral head in the impingement syndrome" 5 (5): 186-193, 1996

13 Lombardi I, "Progressive resistance training in patients with shoulder impingement syndrome: a randomized controlled trial" 59 (59): 615-622, 2008

14 Lombardi I, "Progressive resistance training in patients with shoulder impingement syndrome: a randomized controlled trial" 59 (59): 615-622, 2008

15 Tyc F, "Motor cortex plasticity induced by extensive training revealed by transcranial magnetic stimulation in human" 21 (21): 259-266, 2005

16 van Vliet PM, "Motor control and the management of musculoskeletal dysfunction" 11 (11): 208-213, 2006

17 Schmidt RA, "Motor Control and Learning: a behavioral emphasis Champaign, Ill" Human Kinetics 2005

18 Salmoni AW, "Knowledge of results and motor learning: a review and critical reappraisal" 95 (95): 355-386, 1984

19 Leroux J-.L, "Isokinetic evaluation of rotational strength in normal shoulders and shoulders with impingement syndrome" (304) : 108-115, 1994

20 Tsao H, "Immediate changes in feedforward postural adjustments following voluntary motor training" 181 (181): 537-546, 2007

21 Fitts PM, "Human Performance Belmont" Brooks Cole 1967

22 Reddy AS, "Electromyographic analysis of the deltoid and rotator cuff muscles in persons with subacromial impingement" 9 (9): 519-523, 2000

23 Michener LA, "Effectiveness of rehabilitation for patients with ubacromial impingement syndrome: a systematic review" 17 (17): 152-164, 2004

24 Roy JS, "Effect of motor control and strengthening exercises on shoulder function in persons with impingement syndrome: a single-subject study design" 14 (14): 180-188, 2009

25 On AY, "Differential corticomotor control of a muscle adjacent to a painful joint" 18 (18): 127-133, 2004

26 Flor H, "Cortical reorganisation and chronic pain: implications for rehabilitation" (41 suppl) : 66-72, 2003

27 Winstein CJ, "Conditions of tasks practice for individuals with neurologic impairments. In Textbook of Neural Repair and Rehabilitation" Cambridge University Press 89-102, 2006

28 Senbursa G, "Comparison of conservative treatment with and without manual physical therapy for patients with shoulder impingement syndrome: a prospective, randomized clinical trial" 15 (15): 915-921, 2007

29 Hodges PW, "Changes in motor planning of feedforward postural responses of the trunk muscles in low back pain" 141 (141): 261-266, 2001

30 Ludewig PM, "Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement" 80 (80): 276-291, 2000