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A Combination Approach using Manual Therapy and Exercise in the Treatment of Shoulder Impingement Syndrome
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The purpose of this case study was to compare the effectiveness of traditional physical therapy
interventions of using therapeutic modality and exercise versus a combined approach using
mobilization with movement and exercises in the treatment of shoulder impingement syndrome. A
total of 5 patients diagnosed with shoulder impingement syndrome were selected from the hospital.
Patients then participated in the programs, which were held twice a week for two months. Main
outcome measures included 24-hour pain (VAS), shoulder active range of motion (AROM), and shoulder
function (SPADI). Repeated-measures analysis indicated significant decreases in pain, improved
function, and increases in AROM. The MWM had a higher percentage of change from pre- to posttreatment
on pain measures pain (VAS): 0.6 to 0.2 following 4 session treatment, higher percentage of
change on the SPADI and in AROM.
This study suggests that performing glenohumeral mobilizations with movement (MWM) in combination
with a supervised exercise program may result in a greater decrease in pain and improved function
although studies with larger samples and discriminate sampling methods are needed.
interventions of using therapeutic modality and exercise versus a combined approach using
mobilization with movement and exercises in the treatment of shoulder impingement syndrome. A
total of 5 patients diagnosed with shoulder impingement syndrome were selected from the hospital.
Patients then participated in the programs, which were held twice a week for two months. Main
outcome measures included 24-hour pain (VAS), shoulder active range of motion (AROM), and shoulder
function (SPADI). Repeated-measures analysis indicated significant decreases in pain, improved
function, and increases in AROM. The MWM had a higher percentage of change from pre- to posttreatment
on pain measures pain (VAS): 0.6 to 0.2 following 4 session treatment, higher percentage of
change on the SPADI and in AROM.
This study suggests that performing glenohumeral mobilizations with movement (MWM) in combination
with a supervised exercise program may result in a greater decrease in pain and improved function
although studies with larger samples and discriminate sampling methods are needed.
Keywords
Exercise, Glenohumeral Mobilization, Mobilization with Movement
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- Millar AL, Jasheway PA, Eaton W, et al. A retrospective, descriptive study of shoulder outcomes in outpatient physical therapy. J Orthop Sports Phys Ther 2006;36:403-14.
- McClure PW, Michener LA, Karduna AR. Shoulder function and 3-dimensional scap-ular kinematics in people with and without shoulder impingement syndrome. Phys Ther 2006;86: 1075-1090.
- Belling SAK, Jorgensen U. Secondary impingement in the shoulder. Scand J Med Sci Sports 2000;10: 266-278.
- Williams JW, Holleman DR, Simel DL. Mea-suring shoulder function with the shoulder pain and disability index. J Rheumatol 1995;22:727-32.
- Ludewig PM, Borstad JD. Effects of a home exercise program on shoulder pain and functional status in construction workers. Occup Environ Med 2003;60:841-849.
- Mulligan BR. Manual Therapy Nags, Snags, Mwm, etc, 4th editon. Wellington, NZ: Plane View Series Ltd, 1999.
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