Abstract
A 63-year-old female patient with subacromial impingement syndrome was seen for student physical therapy treatment for 6 sessions over the course of 6 weeks at an outpatient orthopedic clinic under the supervision of a licensed physical therapist. The patient was evaluated at the initial encounter with the Numeric Pain Rating Scale, goniometry, a bubble inclinometer, Manual Muscle Tests, a muscle length test, the Shoulder Pain and Disability Index, passive accessory mobilization examination of the glenohumeral joint (GHJ), Hawkins-Kennedy Test, Resisted External Rotation Test, and the Painful Arc Test. A plan of care was established to address shoulder pain, range of motion (ROM) deficits of hand behind back and horizontal adduction, decreased strength in shoulder and scapular musculature, muscle length deficit of pectoralis minor, decreased shoulder functional mobility and sleep capacity, and limited participation in grocery shopping and homemaking. Main goals for the patient were to decrease pain, increase ROM and strength, improve the ability to perform activities of daily living (ADLs), increase sleep capacity, and to participate in grocery shopping and homemaking with no restrictions. Main interventions used were mobilizations of the GHJ, therapeutic exercise, patient education, and a home exercise program. The patient responded well to physical therapy, resulting in improved pain levels, ROM, strength, ability to perform ADLs, sleep capacity, and participation in grocery shopping and homemaking without restriction. The patient was discharged to her home with a home exercise program.