Fortalecimento excêntrico de manguito rotador na diminuição da dor e melhora funcional em adultos com síndrome do impacto subacromial: revisão narrativa

Abstract

The rotator cuff is the main stabilizing muscle group of the glenohumeral joint during shoulder lift movements, composed of the subscapular, infraspinatus, and minor and supraspinatus muscles. Alterations that compromise these structures make the articular complex of the shoulder to be the target innumerable dysfunctions, among others, the subacromial impact. The subacromial impact syndrome (SIS) is the most common in adult individuals and first described by Neer in 1972. This pathology is characterized by a painful shoulder syndrome, usually accompanied by microtrauma and degeneration of certain structures located in the Subacromial space such as the rotator cuff tendons, the subacromial bursa, the coracoacromial ligament, and the long tendon of the brachial biceps muscle. Its main causes are altered shoulder kinematics, associated with rotator cuff dysfunction and scapular muscles, capsular shortening, dysfunction in joint mobility, poor posture, and excessive use of the upper limbs. It is known that this syndrome is related to shoulder pain symptoms together with loss of functionality. The first action considered to be taken in this case is the conservative treatment. Among the variety of conservative approaches in affections involving muscular tendons, eccentric strengthening has been well studied and has been shown to be effective in the recovery and functional improvement of individuals. Through the eccentric exercise response in tendinopathies, it is indispensable to investigate the existing studies that prove the real benefit of eccentric rotator cuff strengthening as a form of conservative treatment in pain reduction and functional improvement in SIS adults. A literature review of the narrative type was carried out. After reading and analyzing the articles, a total of five articles were selected for analysis of the results. Considering the results found, it can be concluded that the eccentric strengthening of the rotator cuff muscles reduces pain intensity and improves the functional level of SIS adults. Other studies should be performed to determine the ideal protocol of eccentric exercises in individuals with SIS.