Abstract
A 57-year-old female patient with a 4-week history of acute right anterolateral shoulder pain, consistent with possible subacromial impingement syndrome, was seen for outpatient physical therapy for 6 sessions over a 6-week period and 1 additional follow-up session at week 9. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The patient was evaluated with the Numeric Pain Rating Scale, goniometry, manual muscle testing, the Constant-Murley Score for assessment of shoulder functioning, the Patient Specific Functional Scale, and patient report of tolerable duration of exercise and recreational participation. A plan of care was established to address deficits including pain with shoulder active range of motion (AROM), weakness of the glenohumeral and scapular muscles, limitations with activities of daily living (ADL), and restrictions with walking for exercise and participation in recreational writing workshops. Main goals for the patient were to improve pain-free shoulder AROM, scapulohumeral muscle strength, performance of household activities involving shoulder flexion, and tolerable duration of walking for exercise and working at the computer. Main interventions included manual therapy and progressive exercises for strengthening and dynamic stabilization. The patient achieved established goals for the outcomes of pain intensity, shoulder external rotation AROM, scapulohumeral muscle strength, and participation status. She did not attain goals pertaining to pain-free shoulder elevation and desired ADL status compared to baseline function. The patient was discharged to continue living at home with provision of a home exercise program.