Communication breakdown: clinicians disagree on subacromial impingement

Area of Science:

• Orthopedics
• Physical Therapy
• Musculoskeletal Disorders

Background:

• Subacromial impingement syndrome (SIS) is a widely used diagnostic label.
• Its clinical definition and application have become increasingly controversial in scientific literature.

Purpose of the Study:

• To assess and compare the views of orthopedic surgeons and physical therapists on Subacromial Impingement Syndrome (SIS).
• To identify consensus and variations in understanding SIS based on profession and nationality.

Main Methods:

• A survey with 63 visual analog scale (VAS) items was administered to orthopedic surgeons and physical therapists in the US and Netherlands.
• Multivariate regression and cluster analyses were employed to analyze survey data.

Main Results:

• Most survey items received neutral or highly variable ratings, indicating a lack of consensus on SIS.
• Twenty-nine items were associated with SIS (e.g., pain with overhead activities), while seven were considered contradictory (e.g., loss of passive motion).
• Significant differences in perceived etiologies and preferred treatments were observed between surgeons and therapists, and between nationalities.

Conclusions:

• Clinicians hold diverse perspectives on the definition and characteristics of SIS.
• Substantial variations exist even within professional groups, necessitating careful communication regarding SIS.
• The authors recommend cautious utilization of the "subacromial impingement syndrome" diagnostic label.