Turkish Journal of Physical Medicine and Rehabilitation 2007 , Vol 53 , Num 4

Comparing the Effects of Open Versus Closed Kinetic Chain Scapulohumeral Stability Exercises in Rotator Cuff Problems

Berrin Leblebici 1 ,Mehmet Adam 1 ,Serkan Yapgu 2 ,Selda Bağış 3 ,Mahmut Nafiz Akman 4
1 Başkent Üniversitesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Adana Uygulama ve Araştırma Merkezi, Adana, Türkiye
2 Başkent Üniversitesi Tıp Fakültesi, Adana Uygulama ve Araştırma Hastanesi, Adana
3 Acıbadem Üniversitesi, Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Istanbul, Türkiye
4 Başkent Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara

Objective: The aim of this prospective, randomized study was to compare the effects of open and closed kinetic chain scapulohumeral stability exercises in patients with shoulder pain due to rotator cuff problems.

Materials and Methods: Forty patients (32 female, 8 male) were included in this study. One patient had bilateral shoulder involvement. Seventeen patients had impingement syndrome and 24 patients had complete or partial rotator cuff tear. The mean age of the subjects was 55.95±10.12 (mean±SD) (range 32-78 year). Clinical examination and magnetic resonance imaging were used for the diagnosis. Neer and Hawkins impingement tests, supraspinatus isolation test, the degree of painful arc and the pain at the internal and external rotation were evaluated. Functional performance was measured by UCLA (University of California-Los Angeles) test. Clinical and functional evaluations were repeated after the therapy. All patients were treated with a standard physical therapy program, which consisted of hot pack, ultrasound, TENS and exercises, which included range of motion, posture, capsular stretching, strengthening of rotator cuff muscles and sensorymotor training of glenohumeral joint and scapulohumeral stability exercises, by the same therapist for sixth weeks. Scapulohumeral stability exercises were performed randomly as open or closed kinetic chain type.

Results: Clinical tests parameters revealed significant improvement in all patients. Also there was a significant difference between the pre and post therapy total scores and pain subgroup of the UCLA test (p=0.001). However no difference was found between the open and closed kinetic chain exercises groups according to total scores and pain subgroup of the UCLA test (p>0.05).

Conclusion: In patients with rotator cuff lesions, open and closed kinetic chain exercises have the same effect on clinical and functional improvement. 

Keywords : Rotator cuff injury, shoulder rehabilitation, scapulohumeral stability exercises