Positive effects of neuromuscular shoulder exercises with or without EMG-biofeedback, on pain and function in participants with subacromial pain syndrome - A randomised controlled trial

Birgit Juul-Kristensen; Camilla Marie Larsen; Henrik Eshoj; Trine Clemmensen; Anders Hansen; Peter Bo Jensen; Eleanor Boyle; Karen Søgaard

doi:10.1016/j.jelekin.2019.07.009

Positive effects of neuromuscular shoulder exercises with or without EMG-biofeedback, on pain and function in participants with subacromial pain syndrome - A randomised controlled trial

J Electromyogr Kinesiol. 2019 Oct:48:161-168. doi: 10.1016/j.jelekin.2019.07.009. Epub 2019 Jul 31.

Authors

Birgit Juul-Kristensen¹, Camilla Marie Larsen², Henrik Eshoj³, Trine Clemmensen², Anders Hansen⁴, Peter Bo Jensen⁵, Eleanor Boyle⁶, Karen Søgaard⁷

Affiliations

¹ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark. Electronic address: bjuul-kristensen@health.sdu.dk.
² Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Health Sciences Research Center, University College Lillebaelt, Odense, Denmark.
³ Quality of Life Research Center, Department of Haematology, Odense University Hospital, Odense, Denmark.
⁴ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Research Unit for Rehabilitation, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
⁵ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
⁶ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
⁷ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

PMID: 31394380
DOI: 10.1016/j.jelekin.2019.07.009

Abstract

Background: The aim was to investigate the effect of Electromyography (EMG)-biofeedback guided exercises (BIONEX) on shoulder pain and function in participants with subacromial pain syndrome (SPS).

Methods: Twenty-five women and 24 men (19-67 years), diagnosed with SPS, were randomised to BIONEX or the same exercises without EMG-biofeedback (NEX). Primary outcome was shoulder pain during the past 7 days (Numeric Pain Rating Scale (NPRS)). Secondary outcomes included self-reported (Disability of Arm Shoulder and Hand (DASH), Oxford Shoulder Score (OSS)), and measured shoulder function (surface EMG from upper trapezius, lower trapezius and serratus anterior) in mean and ratios of % of maximum voluntary EMG (%MVE) and onset time (msec), during arm tasks with 0, 1 and 3 kg.

Results: There was no group difference (BIONEX versus NEX) in changed shoulder pain (NPRS, mean difference 0.18 (95% CI. -1.56; 1.19)), self-reported or measured shoulder function. Both groups, however, showed significant within-group improvements on self-reported outcomes (NPRS, DASH, OSS), only clinically relevant on NPRS (BIONEX 2.23 (SD 2.47); NEX 2.04 (SD 2.29)).

Conclusion: BIONEX and NEX were both effective in reducing pain to a clinically relevant level, while EMG-biofeedback did not make a difference. The current neuromuscular shoulder exercise protocol is recommended.

Keywords: Biofeedback; Electromyography; Function; Shoulder; Subacromial pain.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Aged
Biofeedback, Psychology*
Electromyography / methods*
Exercise Therapy / methods*
Female
Humans
Male
Middle Aged
Shoulder / physiopathology
Shoulder Impingement Syndrome / therapy*