Physical therapists’ perceptions and use of exercise in the management of subacromial shoulder impingement syndrome: Focus group study

Catherine E. Hanratty, Daniel P. Kerr, Iseult M. Wilson, Martin McCracken, Julius Sim, Jeffrey R. Basford, Joseph G. McVeigh

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background. Shoulder pain resulting from subacromial impingement syndrome (SAIS) is a common problem with a relatively poor response to treatment. There is little research exploring physical therapists’ perspectives on the management of the syndrome. Objectives. The study objective was to investigate physical therapists’ perceptions and experiences regarding the use of exercise in the treatment of patients with SAIS. Design. This was a qualitative focus group study. Methods. Three 60- to 90-minute focus group sessions containing 6 to 8 experienced musculoskeletal physical therapists (total number=20) were conducted. Thematic content analysis was used to analyze transcripts and develop core themes and categories. Results. Exercise was seen as key in the management of SAIS. The overarching theme was the need to “gain buy-in to exercise” at an early stage. The main subtheme was patient education. Therapists identified the need to use education about SAIS etiology to foster buy-in and “sell” self-management through exercise to the patient. They consistently mentioned achieving education and buy-in using visual tools, postural advice, and sometimes a “quick fix” of pain control. Furthermore, experienced practitioners reported including educational interventions much earlier in treatment than when they first qualified. Therapists emphasized the need for individually tailored exercises, including: scapular stabilization; rotator cuff, lower trapezius, and serratus anterior muscle strengthening; and anterior shoulder and pectoralis minor muscle stretching. Quality of exercise performance was deemed more important than the number of repetitions that the patients performed. Limitations. Expanding the geographical area over which the focus groups were conducted and including therapists with less than 5 years of postgraduate experience may have strengthened the findings of this study. Conclusion. Experienced musculoskeletal physical therapists believe that exercise is central in treating patients with SAIS and that gaining patient buy-in to its importance, patient education, promoting self-management, and postural advice are central to the successful treatment of people with SAIS.

Original languageEnglish (US)
Pages (from-to)1354-1363
Number of pages10
JournalPhysical Therapy
Volume96
Issue number9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Shoulder Impingement Syndrome
Physical Therapists
Focus Groups
Exercise
Patient Education
Self Care
Pectoralis Muscles
Education
Shoulder Pain
Rotator Cuff
Superficial Back Muscles
Therapeutics
Pain
Muscles

ASJC Scopus subject areas

  • Medicine(all)
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Hanratty, C. E., Kerr, D. P., Wilson, I. M., McCracken, M., Sim, J., Basford, J. R., & McVeigh, J. G. (2016). Physical therapists’ perceptions and use of exercise in the management of subacromial shoulder impingement syndrome: Focus group study. Physical Therapy, 96(9), 1354-1363. https://doi.org/10.2522/ptj.20150427

Physical therapists’ perceptions and use of exercise in the management of subacromial shoulder impingement syndrome : Focus group study. / Hanratty, Catherine E.; Kerr, Daniel P.; Wilson, Iseult M.; McCracken, Martin; Sim, Julius; Basford, Jeffrey R.; McVeigh, Joseph G.

In: Physical Therapy, Vol. 96, No. 9, 01.09.2016, p. 1354-1363.

Research output: Contribution to journalArticle

Hanratty, CE, Kerr, DP, Wilson, IM, McCracken, M, Sim, J, Basford, JR & McVeigh, JG 2016, 'Physical therapists’ perceptions and use of exercise in the management of subacromial shoulder impingement syndrome: Focus group study', Physical Therapy, vol. 96, no. 9, pp. 1354-1363. https://doi.org/10.2522/ptj.20150427
Hanratty, Catherine E. ; Kerr, Daniel P. ; Wilson, Iseult M. ; McCracken, Martin ; Sim, Julius ; Basford, Jeffrey R. ; McVeigh, Joseph G. / Physical therapists’ perceptions and use of exercise in the management of subacromial shoulder impingement syndrome : Focus group study. In: Physical Therapy. 2016 ; Vol. 96, No. 9. pp. 1354-1363.
@article{9accaa4827ab45c9bf8408ab24902bb6,
title = "Physical therapists’ perceptions and use of exercise in the management of subacromial shoulder impingement syndrome: Focus group study",
abstract = "Background. Shoulder pain resulting from subacromial impingement syndrome (SAIS) is a common problem with a relatively poor response to treatment. There is little research exploring physical therapists’ perspectives on the management of the syndrome. Objectives. The study objective was to investigate physical therapists’ perceptions and experiences regarding the use of exercise in the treatment of patients with SAIS. Design. This was a qualitative focus group study. Methods. Three 60- to 90-minute focus group sessions containing 6 to 8 experienced musculoskeletal physical therapists (total number=20) were conducted. Thematic content analysis was used to analyze transcripts and develop core themes and categories. Results. Exercise was seen as key in the management of SAIS. The overarching theme was the need to “gain buy-in to exercise” at an early stage. The main subtheme was patient education. Therapists identified the need to use education about SAIS etiology to foster buy-in and “sell” self-management through exercise to the patient. They consistently mentioned achieving education and buy-in using visual tools, postural advice, and sometimes a “quick fix” of pain control. Furthermore, experienced practitioners reported including educational interventions much earlier in treatment than when they first qualified. Therapists emphasized the need for individually tailored exercises, including: scapular stabilization; rotator cuff, lower trapezius, and serratus anterior muscle strengthening; and anterior shoulder and pectoralis minor muscle stretching. Quality of exercise performance was deemed more important than the number of repetitions that the patients performed. Limitations. Expanding the geographical area over which the focus groups were conducted and including therapists with less than 5 years of postgraduate experience may have strengthened the findings of this study. Conclusion. Experienced musculoskeletal physical therapists believe that exercise is central in treating patients with SAIS and that gaining patient buy-in to its importance, patient education, promoting self-management, and postural advice are central to the successful treatment of people with SAIS.",
author = "Hanratty, {Catherine E.} and Kerr, {Daniel P.} and Wilson, {Iseult M.} and Martin McCracken and Julius Sim and Basford, {Jeffrey R.} and McVeigh, {Joseph G.}",
year = "2016",
month = "9",
day = "1",
doi = "10.2522/ptj.20150427",
language = "English (US)",
volume = "96",
pages = "1354--1363",
journal = "Physical Therapy",
issn = "0031-9023",
publisher = "American Physical Therapy Association",
number = "9",

}

TY - JOUR

T1 - Physical therapists’ perceptions and use of exercise in the management of subacromial shoulder impingement syndrome

T2 - Focus group study

AU - Hanratty, Catherine E.

AU - Kerr, Daniel P.

AU - Wilson, Iseult M.

AU - McCracken, Martin

AU - Sim, Julius

AU - Basford, Jeffrey R.

AU - McVeigh, Joseph G.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background. Shoulder pain resulting from subacromial impingement syndrome (SAIS) is a common problem with a relatively poor response to treatment. There is little research exploring physical therapists’ perspectives on the management of the syndrome. Objectives. The study objective was to investigate physical therapists’ perceptions and experiences regarding the use of exercise in the treatment of patients with SAIS. Design. This was a qualitative focus group study. Methods. Three 60- to 90-minute focus group sessions containing 6 to 8 experienced musculoskeletal physical therapists (total number=20) were conducted. Thematic content analysis was used to analyze transcripts and develop core themes and categories. Results. Exercise was seen as key in the management of SAIS. The overarching theme was the need to “gain buy-in to exercise” at an early stage. The main subtheme was patient education. Therapists identified the need to use education about SAIS etiology to foster buy-in and “sell” self-management through exercise to the patient. They consistently mentioned achieving education and buy-in using visual tools, postural advice, and sometimes a “quick fix” of pain control. Furthermore, experienced practitioners reported including educational interventions much earlier in treatment than when they first qualified. Therapists emphasized the need for individually tailored exercises, including: scapular stabilization; rotator cuff, lower trapezius, and serratus anterior muscle strengthening; and anterior shoulder and pectoralis minor muscle stretching. Quality of exercise performance was deemed more important than the number of repetitions that the patients performed. Limitations. Expanding the geographical area over which the focus groups were conducted and including therapists with less than 5 years of postgraduate experience may have strengthened the findings of this study. Conclusion. Experienced musculoskeletal physical therapists believe that exercise is central in treating patients with SAIS and that gaining patient buy-in to its importance, patient education, promoting self-management, and postural advice are central to the successful treatment of people with SAIS.

AB - Background. Shoulder pain resulting from subacromial impingement syndrome (SAIS) is a common problem with a relatively poor response to treatment. There is little research exploring physical therapists’ perspectives on the management of the syndrome. Objectives. The study objective was to investigate physical therapists’ perceptions and experiences regarding the use of exercise in the treatment of patients with SAIS. Design. This was a qualitative focus group study. Methods. Three 60- to 90-minute focus group sessions containing 6 to 8 experienced musculoskeletal physical therapists (total number=20) were conducted. Thematic content analysis was used to analyze transcripts and develop core themes and categories. Results. Exercise was seen as key in the management of SAIS. The overarching theme was the need to “gain buy-in to exercise” at an early stage. The main subtheme was patient education. Therapists identified the need to use education about SAIS etiology to foster buy-in and “sell” self-management through exercise to the patient. They consistently mentioned achieving education and buy-in using visual tools, postural advice, and sometimes a “quick fix” of pain control. Furthermore, experienced practitioners reported including educational interventions much earlier in treatment than when they first qualified. Therapists emphasized the need for individually tailored exercises, including: scapular stabilization; rotator cuff, lower trapezius, and serratus anterior muscle strengthening; and anterior shoulder and pectoralis minor muscle stretching. Quality of exercise performance was deemed more important than the number of repetitions that the patients performed. Limitations. Expanding the geographical area over which the focus groups were conducted and including therapists with less than 5 years of postgraduate experience may have strengthened the findings of this study. Conclusion. Experienced musculoskeletal physical therapists believe that exercise is central in treating patients with SAIS and that gaining patient buy-in to its importance, patient education, promoting self-management, and postural advice are central to the successful treatment of people with SAIS.

UR - http://www.scopus.com/inward/record.url?scp=84985914220&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84985914220&partnerID=8YFLogxK

U2 - 10.2522/ptj.20150427

DO - 10.2522/ptj.20150427

M3 - Article

C2 - 27013575

AN - SCOPUS:84985914220

VL - 96

SP - 1354

EP - 1363

JO - Physical Therapy

JF - Physical Therapy

SN - 0031-9023

IS - 9

ER -