Faculty Advisor(s)

Kirsten Buchanan

Document Type

Course Paper

Publication Date

12-12-2014

Abstract

Background: Subacromial impingement results from repetitive trauma to structures underneath the subacromial arch leading to a decrease in the subacromial space, impingement of soft tissue, and ultimately a decrease in functional abilities. Conservative treatment includes physical therapy, nonsteroidal anti-inflammatory drugs, and corticosteriod injections. If improvements are not observed, there is a surgical option of a subacromial decompression (SAD). Conclusive evidence supporting surgery over conservative measures does not exist1. Literature is lacking regarding SAD without rotator cuff (RTC) repair and performing SAD with both an acromioplasty and bursectomy. Therefore, the purpose of this case report was to investigate the functional outcomes of a patient after SAD with an acromioplasty and bursectomy without RTC involvement. Case Description: SA was a 52 year old female presenting to outpatient physical therapy after left arthroscopic SAD. SA reported onset of shoulder pain in 2013. Conservative physical therapy was successful in improving symptoms until a fall exacerbated her symptoms. She continued conservative therapy but it failed to improve her pain and function. Two months later she had a SAD with an acromioplasty and bursectomy. Physical therapy treatments included therapeutic exercises, home exercise program, functional activities, modalities, manual therapy, and posture re-education with the primary focus of reducing pain, improving ROM and improving functional ability. Outcomes: Improvements were observed 41 in left shoulder active and passive ROM, strength, pain, and functional outcomes. Discussion: Outcomes indicated that therapeutic exercises, manual therapy, and modalities following arthroscopic SAD with both an acromioplasty and bursectomy were beneficial for a patient without RTC involvement. More research is needed to support the advantages of this procedure combined with physical therapy in improving functional outcomes.

Comments

The case report poster for this paper can be found here: http://dune.une.edu/pt_studcrposter/39.

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