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 (p = 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.