Effects of a Scapular-Focused Exercise Protocol for Patients with Rotator Cuff-Related Pain Syndrome-A Randomized Clinical Trial.

Background: Current clinical practice still lacks consistent evidence in the physiotherapy management of rotator cuff-related pain syndrome (RCS). The purpose of this trial was to compare the effectiveness of a scapular-focused treatment with and without real-time electromyographic biofeedback (EMGBF) to a control therapy in patients with RCS, in the short-term. Methods: 60 patients with RCS were divided into three groups: the scapular-focused exercise protocol group (P_G n = 20), the scapular-focused exercise protocol with EMGBF group (P+EMGBF_G n = 20), and the control therapy group (CT_G n = 20). Values of pain and function [Shoulder Pain and Disability Index (SPADI) questionnaire, complemented by the Numeric Pain Rating Scale (NPRS) and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire], scapular stabilizer neuromuscular control (SSNC), scapular stabilizer activation onset (SSAO), dynamic scapular alignment, range of motion (ROM), and glenohumeral flexor and abductor muscle strength (GMS) were assessed at baseline and after 6 weeks and compared within and between groups. Results: There were significant differences in pain and function, SSNC, SSAO, dynamic scapular alignment, ROM, and GMS in all groups between the initial and 6-week assessments. However, the P+EMGBF_G showed superior results in pain and function, SSNC, and dynamic scapular alignment than the CT_G and superior results in SSNC than the P_G. The P_G had superior results in pain and function and dynamic scapular alignment than the CT_G. Conclusions: This trial supports the use of a scapular-focused exercise protocol as a comparative approach that effectively improves pain and function in patients with rotator cuff-related shoulder pain syndrome. These results in pain and function were shown to be independent of the use of EMGBF.