The Effect of Humeral Head Depressor Strengthening on Individuals with Subacromial Impingement Syndrome
Bibliographic record
Abstract
Background and Objectives: Subacromial pain syndrome (SAPS) is one of the most common musculoskeletal problems affecting the shoulder joint. In this study, we aimed to investigate the effectiveness of a rehabilitation program targeting humeral head depressor muscles on symptoms in individuals with SAPS. Materials and Methods: Participants were sequentially assigned to study and control groups in a quasi-randomized design. While the control group received standard physical therapy and rehabilitation, the study group underwent a combined progressive exercise program, including humeral head depressor strengthening, peri-articular muscle exercises, scapular stabilization, and proprioceptive training. Acromio–humeral distance (AHD) and tendon thickness measurements were evaluated via ultrasonography (USG), while pain intensity, upper-extremity disability, and kinesiophobia were measured using the VAS and McGill Pain Questionnaire, DASH-T, and the Fear Avoidance Beliefs Questionnaire, respectively. Results: Both the study and control groups showed statistically significant increments in AHD compared to the baseline. The first and final measurements changed from 7.92 mm to 10.54 mm and from 7.72 mm to 8.41 mm, respectively. However, the increase in AHD was greater in the study group relative to the control group, and the value was statistically significant. The study group showed significant improvements in pain and disability. Kinesiophobia levels, on the other hand, decreased in both groups, but a greater decrease was observed in the study group. Conclusions: In this study, both the study and control groups showed an increase in AHD, but the combined exercise program targeting humeral head depressor muscles resulted in a greater improvement. Reduced tendon thickness indicated the eased motion of the rotator cuff, supporting the improvements in pain and disability. The program had a positive impact on psychosocial parameters, including pain-related kinesiophobia. Given the limited literature on the effects of such exercises on AHD and tendon thickness, this study provides an original contribution. Clinical Trial Registration: ClinicalTrials.gov identifier: NCT07228455.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".