Postural Alterations in Patients with Subacromial Impingement Syndrome

Alizadehkhaiyat, Omid and Roebuck, Margaret M. and Makki, Ahmed T and Frostick, Simon P. Postural Alterations in Patients with Subacromial Impingement Syndrome. International Journal of Sports and Physical Therapy, 12 (7). pp. 1111-1120. ISSN 2159-2896 (Accepted for Publication)

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Background: An aberrant upper body posture has been proposed as one of the etiological factors contributing to the development of subacromial impingement syndrome (SAIS). Clinicians have translated this supposition into assessment and rehabilitation programs despite insufficient and conflicting evidence to support this approach.

Purpose: The purpose of this study was to compare several postural variables between the SAIS patients and asymptomatic healthy controls.

Study Design: Case-Control Study

Methods: A total of 75 participants including 39 patients (20 females; 19 males) and 36 healthy controls (15 females; 21 males) participated in the study. Study evaluated several postural variables including forward head posture (FHP), forward shoulder posture (FSP), thoracic kyphosis index (TKI), scapular index (SI), normalized scapular protraction (NSP), and the lateral scapular slide test (LSST). The variables were compared between patient and control groups according to sex.

Results: Significant differences were observed in the female patients compared to asymptomatic controls for the FHP (49.3o+9.6o vs 55.5o+8.3o, p=0.03), FSP (45.5o+10.1o vs 53.6o+7.0o, p=0.02), and LSST in third position (10.2+2.1cm vs 11.5+0.7cm, p=0.01). Male patients showed a significant difference only in the FSP compared to controls (61.9o+9.4o vs 49.7o+9.2o, p<0.001).

Conclusions: While inadequate data on the relationship between dysfunctional posture and SAIS has led to broad variations in current rehabilitation strategies, the results of the present study revealed different patterns of postural aberrations in female and male patients with SAIS. This clarifies the need to develop individualized or sex-specific approaches for assessing posture in men and women with SAIS and rehabilitation programs based on the assessment results.

Level of Evidence: 4

Item Type: Article
Additional Information and Comments: This is the author's version of an article that has been accepted for publication in the International Journal of Sports and Physical Therapy. The final, published version is available at
Keywords: Forward Head Posture; Forward Shoulder Posture; Postural Assessment; Scapula Positioning; Shoulder Impingement; Thoracic Kyphosis
Faculty / Department: Faculty of Science > School of Health Sciences
Depositing User: Omid Khaiyat
Date Deposited: 17 Nov 2017 09:39
Last Modified: 08 Jan 2018 14:22

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