The Immediate Effect of Subacromial Injection and Soft Tissue Mobilization: An Analysis of Scapular Control in Patients with Subacromial Impingement Syndrome

• Main Authors: Po-Tsun Chen, 陳柏村
• Other Authors: Wen-Ling Chen
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/60652009500972839507

碩士 === 國立成功大學 === 物理治療研究所 === 96 === Background: Patients with subacromial impingement syndrome(SAIS) have been reported to demonstrate increased upper trapezius(UT) and reduced serratus anterior(SA) muscle activities during arm elevation. While subacromial injection is commonly used in clinical orthopedics for the reduction of pain and inflammation and soft tissue mobilization were recommended to decrease local muscle spasm and hypertonicity, no studies have investigated the effect of subacromial injection or UT soft tissue mobilization on scapular control in patients with SAIS. Purpose: The study aimed to examine the immediate effect of subacromial injection or UT soft tissue mobilization on scapular control and related symptoms in patients with SAIS. Methods: 17 subjects with SAIS were included to take subacromial injection. Pain status, range of motion(ROM) of shoulder, strength of shoulder rotators, and scapular muscles activities including UT, SA, middle deltoid(MD), and loer trapezius(LT) were measured during scaption before and after injection. The assessment of shoulder pain and disability index(SPADI) was finished before and follow-up 1 week after injection(n=9). 10 patients with injection 1 week ago and another 5 SAIS patients without subacromial injection were recruited. They received soft tissue mobilization treatment on UT(n=15). The flexibility of UT and scapular muscles activities during scaption were measured before and after soft tissue mobilization. Results: Significantly reduced pain scale, increased shoulder ROM, increased strength were found after injection(n=17, p<0.05). During scaption 30°-60°, the activities of SA and MD were increased significantly after injection. Significant pain reduction 1 week after injection was found, compared to the status before injection(n=9, p<0.05), and SPADI showed significant improvement 1 week after injection. Shoulder ROM and rotators strength were improved 1 week after injection, but no significant changes found(n=9, p=0.44~0.96 ). The activities of scapular muscles during scaption were generally decreased, especially during initial and late scaption phase. The flexibility of UT was increased significantly after UT mobilization. In the initial phase of scaption, significant increased activities of SA and LT were found. Conclusion: This study not only examine the immediately effect of subacromial injection on pain reduction and strength and ROM improvement, but provided the evidence of scapular muscles contributions during scaption after pain reduction. The scapular muscle strengthening should be followed after injection, since the effect of injection may not be maintained about 1 week. This study was the first research about soft tissue mobilization on UT and demonstrated the changed scapular muscle activities after UT soft tissue mobilization. The significantly increased flexibility of UT and activities of SA was found after UT soft tissue mobilization.