Evidence map›Paper›PMID 39971090›Full record

ArticleJournal of shoulder and elbow surgery2025

Voluntary activation is impaired in subacromial pain syndrome but improves with pain relief and exercise.

Kshamata M Shah, Daniel W Safford, Kathleen Madara, Jennifer Cooper, Brett Sweitzer, Andrew Karduna, Philip W McClure

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of shoulder and elbow surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kshamata M ShahDepartment of Physical Therapy, Arcadia University, Glenside, PA, USA. Electronic address: shahk@arcadia.edu.
Daniel W SaffordDepartment of Physical Therapy, Arcadia University, Glenside, PA, USA.
Kathleen MadaraDepartment of Physical Therapy, Moravian University, Bethlehem, PA, USA.
Jennifer CooperDepartment of Human Physiology, University of Oregon, Eugene, OR, USA.
Brett SweitzerOrthoKagan, Fort Myers, FL, USA.
Andrew KardunaDepartment of Human Physiology, University of Oregon, Eugene, OR, USA.
Philip W McClureDepartment of Physical Therapy, Arcadia University, Glenside, PA, USA.

Funding

Neurophysiology of Weakness and Exercise in Rotator Cuff TendinopathyR01AR063713 · NIAMS · UNIVERSITY OF OREGON · PI KARDUNA, ANDREW ROBERT · 2014 to 2018
$1.7M
NIAMS NIH HHS R01 AR063713
6 · The paper itself

Abstract

HYPOTHESIS AND

backgroundShoulder exercise and subacromial injection are the first line of treatment for patients with subacromial pain syndrome (SAPS) and have been shown to be effective in about 70% of patients. Weakness is common in these patients although its true source is uncertain. The purpose of this study is to determine the changes in rotator cuff voluntary activation (VA), that is, central drive and force, immediately after a pain-relieving subacromial injection, and following a 6-week exercise program and examine baseline differences in patients with SAPS and healthy controls.

methodsVoluntary activation, peak normalized external rotation (ER) torque, pain, and self-report function were assessed in 43 patients with positive shoulder impingement. Subjects were tested at baseline (T1), immediately after a pain-relieving injection (T2), and after 6 weeks of exercise (T3). Forty-4 controls were tested at baseline (T1). Participants received 2 stimuli on their infraspinatus, one while contracting maximally and one at rest, to determine the VA.

resultsSubjects with SAPS demonstrated lower ER normalized torque (27.3% lower compared with controls, P = .005) and lower infraspinatus VA (median 0.99 in controls and 0.71 in patients, P < .001). As expected, the VA increased (P = .004) from T1 to T2 and remained unchanged at T3 as compared to T2. ER normalized torque increased across all time points. Pain (P < .001) decreased with the injection and exercise, and function (P < .001) improved from baseline to discharge. DISCUSSION: Understanding neural adaptations with exercise is critical to learning how to best modify the system and optimize current rehabilitation strategies, for example, including exercises focused on motor-control training, biofeedback, or neuromuscular electric stimulation.

Indexed as

Exercise TherapyRotator CuffShoulder Impingement SyndromeShoulder PainAdultAgedFemaleHumansInjections, Intra-ArticularMaleMiddle AgedPain MeasurementTreatment Outcomecentral activationexerciseinfraspinatuspainShoulder muscle activitytendinopathy

Identifiers

PMID39971090
PMCPMC12068981

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.