Abstract
"Subacromial impingement syndrome (SIS)" is often used as a diagnostic label, but has become more controversial as such in the literature. We assessed views on SIS in clinical practice using a survey with 63 0-10 VAS items among orthopedic surgeons and physical therapists from the United States and the Netherlands. Multivariate regression and cluster analyses were applied to identify consensus items and to study profession and/or nationality effects on item ratings. Most items received neutral or highly variable ratings. Twenty-nine were considered associated with SIS, including worsening of pain with overhead activities, painful arc and a positive Neer's test. Seven items were regarded pleading against SIS, including loss of passive motion. Activity modifications and physical therapy are the most important treatments according to therapists, who highly valued motion-related etiologic mechanisms. Surgeons, with higher ratings for intrinsic and anatomic etiologies, appreciated the use of subacromial corticosteroids and surgery. Clinicians from different professional backgrounds have different views on what SIS is, and even within professional groups, variations are substantial. This has to be taken into account when communicating about SIS symptoms, for example, in intercollegial consultation or scientific research. The authors suggest cautious use of (subacromial) impingement syndrome as a diagnostic label.
Original language | English (US) |
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Pages (from-to) | 221-231 |
Number of pages | 11 |
Journal | Medical and Biological Engineering and Computing |
Volume | 52 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2014 |
Bibliographical note
Funding Information:Acknowledgments The authors would like to acknowledge T.P. Vliet-Vlieland, MD, Ph.D. (Department of Orthopaedics, Leiden University Medical Center, the Netherlands), D.C. Boonman, P.T., and H.M. Vermeulen, P.T., Ph.D. (Department of Physical Therapy, Leiden University Medical Center, the Netherlands) for their screening of the first version of the applied questionnaire, M.A. Hoelen, M.D., for his cooperation in contacting Dutch Orthopaedic shoulder surgeons, and all participating surgeons and physical therapists for filling out the extensive questionnaire. This study is part of a larger project funded by ZonMw, the Netherlands Organization for Health Research and Development (NOW) (grant number 40-00703-98-8564) and the Dutch Arthritis Association (grant number 09-1-303).
Keywords
- Consensus
- Diagnosis
- Rotator cuff
- Shoulder impingement syndrome
- Treatment