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.
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 language | English |
|---|---|
| Pages (from-to) | 1354–1363 |
| Journal | Physical Therapy |
| Volume | 96 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 01 Sept 2016 |