Author(s): HUANG, T., ZOU, H.L., ZHANG, W., LIU, H.Y., YAN, B., Institution: BEIJING SPORT UNIVERSITY, Country: CHINA, Abstract-ID: 1999

INTRODUCTION:
Chronic shoulder pain (CSP) affects 50%–91% of overhead athletes, severely impacting their training and competition [1]. Although scapular stabilization exercise (SSE) is a first-line treatment, it has a limited and slow effect on pain relief [2]. This study introduces an integrated approach combining active motor control with myofascial release (AMC-MR), aiming to enhance pain relief and functional recovery in overhead athletes with CSP [3].
METHODS:
Twenty-four overhead athletes with CSP were randomized into AMC-MR and SSE groups for a 6-week intervention. The AMC-MR group received treatment weekly, while the SSE group had sessions three times weekly. Primary outcomes were pain intensity assessed by the Numeric Rating Scale (NRS, 0-10 scale), including present, average, and most severe pain intensity. Secondary outcomes included Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC) for patient-reported outcomes, active range of motion (AROM), and maximum isometric muscle strength (MIMS). Average and most severe pain intensity and KJOC were assessed at baseline and 6 weeks. Present pain intensity, AROM, and MIMS were assessed at baseline, after the first session, and at 6 weeks.
RESULTS:
All participants completed the study without dropouts. For primary outcomes, present pain intensity was 4.00±1.21 in the AMC-MR group and 4.16±1.53 in the SSE group at baseline. The AMC-MR group showed a significant reduction in present pain intensity after the first session (1.08±1.38) and at 6 weeks (0.75±0.97), surpassing the SSE group significantly after the first session (P=0.02), with the SSE group also noting significant present pain relief at 6 weeks (1.83±1.89). Both groups showed considerable improvements in average and most severe pain intensity at 6 weeks. Secondary outcomes revealed significant improvements in both groups for KJOC, and shoulder abduction and flexion at 6 weeks, with the AMC-MR group showing superior improvement in KJOC (P=0.02). The AMC-MR group also notably enhanced AROM including external rotation, internal rotation, abduction, and flexion after the first session, with external rotation improvements outperforming the SSE group (P=0.01). No significant changes were observed in MIMS for the serratus anterior and trapezius in either group.
CONCLUSION:
AMC-MR has shown clear advantages in both rapid pain relief and improved function, as well as duration of efficacy.
References:
1. Kibler WB, Sciascia AD, Hrsg. Disorders of the Scapula and Their Role in Shoulder Injury: A Clinical Guide to Evaluation and Management. Cham: Springer International Publishing; 2017.
2. Nodehi Moghadam A, Rahnama L, Noorizadeh Dehkordi S, et al. Exercise therapy may affect scapular position and motion in individuals with scapular dyskinesis: a systematic review of clinical trials. J Shoulder Elbow Surg 2020; 29: e29–e36.
3. Schleip R. FASCIA AS A SENSORY ORGAN: Clinical Applications. Terra Rosa E-Mag 2017; 20: 2–7.