Original article Effects of a movement training oriented rehabilitation program on symptoms, functional limitations and acromiohumeral distance in individuals with subacromial pain syndrome Alexandre Savoie a , Catherine Mercier a, b , François Desmeules c, d , Pierre Fr  emont b, e , Jean-S  ebastien Roy a, b, * a Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada G1M 2S8 b Department of Rehabilitation, Faculty of Medicine, Universit e Laval, Quebec City, Quebec, Canada G1R 1P5 c Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada d School of Rehabilitation, Faculty of Medicine, Universit e de Montr eal, Montr eal, Quebec, Canada e Centre de recherche du Centre Hospitalier Universitaire de Qu ebec, Quebec City, Quebec, Canada article info Article history: Received 29 August 2014 Received in revised form 24 March 2015 Accepted 2 April 2015 Keywords: Shoulder pain Motor control Motor learning Ultrasonographic measures abstract Background: Multiple factors have been associated with the presence of a subacromial pain syndrome (SPS), including deficits in performance of scapular and glenohumeral muscles. Such deficits can lead to inadequate kinematics and decreased acromiohumeral distance (AHD). Exercises that aim at correcting these deficits, such as movement training, were suggested to improve symptoms and functional limi- tations. To date, few studies have assessed outcomes following an intervention focused on movement training. Objectives: Evaluate the effects of a rehabilitation program based on movement training on symptoms, functional limitations and AHD in individuals with SPS. Design: Prospective single group pre-post design. Methods: Twenty-five participants with SPS (SPS group) participated in a 6-week program. Twenty asymptomatic volunteers were recruited for normative AHD values (control group). Outcomes of both groups were evaluated at baseline and 6 weeks, i.e. immediately following intervention for the SPS group. Changes in symptoms and functional limitations for SPS group were assessed using the Western Ontario Rotator Cuff (WORC) index and Disability of the Arm Shoulder and Hand (DASH) questionnaire. Changes in AHD for both groups were assessed using ultrasonographic measures. Results: Following the rehabilitation program, the scores on WORC and DASH were significantly improved (p < 0.001). AHD increased significantly in the SPS group (p ¼ 0.019), especially in a subgroup with initial deficits (p < 0.001). Conclusion: The rehabilitation program yielded improvements in symptoms and functional limitations in participants with SPS. Moreover, it led to an increase of the AHD e thus potentially decreasing sub- acromial compression, particularly in participants with an initially smaller AHD. The trial was registered at ClinicalTrials.gov: identifier e NCT02395770. © 2015 Elsevier Ltd. All rights reserved. 1. Introduction Subacromial pain syndrome (SPS) is frequently termed impingement syndrome based on the underlying mechanisms, which include encroachment of the subacromial space soft tissues underneath the coracoacromial arch as the arm is elevated (Bigliani and Levine, 1997). It is hypothesized that decreased or delayed activation of scapulohumeral and scapulothoracic muscles could * Corresponding author. Centre interdisciplinaire de recherche en r eadaptation et en int egration sociale (CIRRIS), 525, boulevard Wilfrid-Hamel, local H-1710, Qu ebec, QC G1M 2S8, Canada. Tel.: þ1 418 529 9141x6005; fax: þ1 418 529 3548. E-mail addresses: alexandre.savoie@fmed.ulaval.ca (A. Savoie), catherine. mercier@rea.ulaval.ca (C. Mercier), f.desmeules@umontreal.ca (F. Desmeules), pierre.fremont@fmed.ulaval.ca (P. Fr emont), jean-sebastien.roy@rea.ulaval.ca (J.-S. Roy). Contents lists available at ScienceDirect Manual Therapy journal homepage: www.elsevier.com/math http://dx.doi.org/10.1016/j.math.2015.04.004 1356-689X/© 2015 Elsevier Ltd. All rights reserved. Manual Therapy xxx (2015) 1e6 Please cite this article in press as: Savoie A, et al., Effects of a movement training oriented rehabilitation program on symptoms, functional limitations and acromiohumeral distance in individuals with subacromial pain syndrome, Manual Therapy (2015), http://dx.doi.org/10.1016/ j.math.2015.04.004