Physical therapists’ perceptions and use of exercise in the management of subacromial shoulder impingement syndrome: Focus Group Study

Catherine Hanratty, Daniel Paul Kerr, Iseult M Wilson, Martin McCracken, Julius Sim, Jeffrey R Basford, Joseph G McVeigh

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Abstract

Background: Shoulder pain resulting from subacromial impingement syndrome (SAIS) is a common problem with a relatively poor response to treatment. There is little research exploring physical therapists’ perspectives on the management of the syndrome.Objectives: To investigate physical therapists’ perceptions and experiences regarding the use of exercise in the treatment of patients with SAIS.Design: Qualitative focus group study. Methods: Three 60–90 minute focus group sessions containing 6–8 experienced musculoskeletal physical therapists (total n=20) were conducted. Thematic content analysis was used to analyse transcripts and develop core themes and categories.Results: Exercise was seen as key in the treatment of SAIS. The overarching theme was the need to “gain buy-in to exercise” at an early stage. The main subtheme was patient education. Therapists identified the need to use education about SAIS etiology to foster buy-in and “sell” self-management through exercise to the patient. They consistently mentioned achieving education and buy-in using visual tools, postural advice and sometimes a “quick fix” of pain control. Furthermore, experienced practitioners reported including educational interventions much earlier in treatment than when they first qualified. Therapists emphasized the need for individually tailored exercises including: scapular stabilization; rotator cuff, lower trapezius and serratus anterior strengthening; and anterior shoulder and pectoralis minor stretching. Quality of exercise performance was deemed more important than the number of repetitions that the patient performed. Conclusion: Experienced musculoskeletal physical therapists believe that exercise is central in managing patients with SAIS, and that gaining patient buy-in to its importance, patient education, promoting self-management, and postural advice are central to the successful management of people with SAIS.
Original languageEnglish
Pages (from-to)1354-1363
JournalPhysical Therapy
Volume96
Issue number9
Early online date24 Mar 2016
DOIs
Publication statusPublished - 1 Sep 2016

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Keywords

  • Sub-acromial impingement
  • SAIS

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