Key result
Low load resistance training with blood flow restriction produced clinically meaningful improvements in pain, function, and strength in two patients with subacromial impingement syndrome.
Why the study?
Patients with subacromial impingement syndrome often experience pain during heavy resistance training, limiting standard strengthening, and blood flow restriction training may provide a viable modification.
Does blood flow restriction training improve pain and function in patients with subacromial impingement syndrome?
Case Report (n=2)
No
Does blood flow restriction training improve pain and function in patients with subacromial impingement syndrome?
Low load resistance training with blood flow restriction may be a useful adjunct for treating patients with subacromial impingement syndrome to decrease pain and increase upper extremity function.
Should not yet change practice in subacromial impingement; hypothesis-generating case data requiring randomized confirmation.
Introduction: Evidence informed management of individuals presenting with subacromial impingement syndrome (SAIS) includes strengthening exercises directed at the shoulder musculature. Patients with subacromial impingement syndrome (SAIS) can present with pain during and after completion of heavy resistance training limiting the applicability of this recommended treatment approach. Blood flow restriction (BFR) training is indicated for patients who have pain while completing heavy resistance training and may represent an important treatment modification for patients with SAIS unable to fully participate in a strengthening exercise program. The purpose of this case series is to describe the inclusion of BFR in the treatment of two patients with SAIS. Case descriptions: Two middle aged, non-operative patients with signs and symptoms consistent with SAIS and high levels of irritability were included. Treatment over one month consisted of three commonly used exercises in the treatment of SAIS in conjunction with a standard BFR protocol: 75 reps broken up into sets of 30,15,15,15 with the BFR cuff placed over proximal humerus. Outcomes: Immediate within session improvements beyond measurement error were observed in resting pain and pain pressure thresholds at three sites. At the end of the course of treatment, clinically meaningful improvements were observed in patient reported outcomes including the PENN Score, ASES score, and the patient-specific functional scale. Clinically meaningful improvements and change beyond measurement error were also observed in range of motion and strength which (assessed via a handheld dynamometer). Discussion: The incorporation of low load resistance training with BFR may be a useful adjunct for treating patients with SAIS to promote exercise-induced hypoalgesia, decrease pain, and increase function in the upper extremity. Level of Evidence: 5.
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Ceballos et al. (2022) conducted a case report in Subacromial impingement syndrome (SAIS) (n=2). Blood flow restriction (BFR) with strengthening exercises was evaluated on Patient-reported outcomes (PENN, ASES, SANE, PSFS), pressure pain threshold, and strength. Low load resistance training with blood flow restriction produced clinically meaningful improvements in pain, function, and strength in two patients with subacromial impingement syndrome.
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