Effectiveness of physiotherapy and costs in patients with clinical signs of shoulder impingement syndrome

This study aimed to investigate the effect of manual physiotherapy and exercises in comparison to exercises alone in patients with shoulder impingement syndrome one year post-inclusion. Individualized manual physiotherapy plus individualized exercises were administered to the intervention group; the control group received individualized exercises only. Both groups had 10 treatments over 5 weeks; following initial treatment all patients continued their exercises for another 7 weeks at home. Primary outcomes were the Shoulder Pain and Disability Index and Patients’ Global Impression of Change. The Generic Patient-Specific Scale was used as secondary outcome. Costs were recorded in a log-book. Ninety patients were included in the study and 87 could be analyzed at 1-year follow-up. Both groups showed significant improvements in all outcome measures, but no difference was found between the groups. Only costs differed significantly in favour of the control group (pā€‰=ā€‰0.03) after 5 weeks.

Individualized exercises resulted in lower costs than manual physiotherapy and exhibited a significant effect on pain and functioning within the whole group after one year. Exercises should therefore be considered as a basic treatment. Because of the ongoing improvement that occurred during the follow-up period with individualized exercises additional treatments should be delayed for 3 to 4 months.