OBJECTIVE: To evaluate the effect of individualized exercises based on movement fault (MF) control on pain intensity, and disability in subjects with chronic subacromial pain syndrome (SAPS).
DESIGN: Randomized controlled trial.
SETTING: Rehabilitation clinics.
PARTICIPANTS: Thirty-eight participants with chronic SAPS (mean [SD] age, 52.23 (8.47); 60 % women).
INTERVENTIONS: The participants were randomly allocated to 1 of the intervention groups (individualized exercises based on MFs control test designed to target specific movement faults) or the control group (commonly prescribed general scapular stabilization exercises). Both groups received exercise sessions twice a week for 4 weeks.
MAIN OUTCOME MEASURES: The primary outcome measures were pain intensity at rest (PR) and during arm raising (PAR) using a visual analog scale. Disability was assessed as a key secondary outcome, including the disabilities of the arm, shoulder, and hand (DASH) questionnaire and the Shoulder Pain and Disability Index (SPADI).
RESULTS: Following completion of all exercise sessions, PAR was significantly lower in the intervention group compared to the control group (mean, 9.17; 95% confidence interval; 0.31-18.03; P=.04), with a large effect size (0.68). The reduction of PAR remained significantly lower in the intervention group than in the control group after 4 months of follow-up (mean, 18.29; 95% confidence intervals [CI], 9.09-27.48; P<.00) with a large effect size (1.27). Disability significantly decreased at 2-month (mean, 14.58, P=.002 on SPADI index; mean, 10.26, P=.006 on DASH index) and 4-month (mean, 19.85, P<.001 on SPADI index; mean, 12.09, P=.001 on DASH index) follow-ups in the intervention group compared to the control group.
CONCLUSION: Individualized exercises based on MFs control of the shoulder region was accompanied by decreased PAR and disability in subjects with SAPS.
| Discipline Area | Score |
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| Physician |  |
| Rehab Clinician (OT/PT) |  |
Physician rater
This study is highly relevant and moderately novel in PM&R. It provides early evidence supporting individualized motor-control-based rehabilitation for SAPS that may influence future clinical pathways, especially for patients not responding to generalized protocols. The integration of movement-fault analysis is particularly valuable in advancing biomechanically-informed rehabilitation.
Physician rater
Most PTs and OTs would want to see the video of the individualized stabilization exercise therapy.
Rehab Clinician (OT/PT) rater
Nice to see an RCT that confirms the general clinical consensus that a tailored (and observed) exercise approach is more effective than a general exercise program.
Prof. Mike Poling (5/8/2025 9:51 AM)
If it shocks anyone that a specific exercise program targeted to the individual and condition has a better outcome than a generalized program that isn't specific to patient or condition, then I invite you to look at whether random medication prescription or a specific medication prescription would be more beneficial for patients. Seriously, this needed a study?
, McMaster University