Effect of Training Environment on Pain, Stability, Functional Disability, and Motor Control in Swimmers with Shoulder Impingement Syndrome

Aims: Shoulder impingement syndrome (SIS) is a prevalent issue in swimmers, impacting pain, stability, and motor control. This study compares the effects of various training environments on these outcomes in swimmers with SIS.Method: Thirty female swimmers with SIS were randomly assigned to land-based training (LBT, n=۱۵) or water-based training (WBT, n=۱۴) groups. Assessments included pain (VAS), stability (Upper Quarter Y-Balance Test), functional disability (DASH), and proprioception (JPS error), measured pre- and post-intervention. The ۲۴-session programs involved progressive stretching and resistance exercises, with intensity adjusted biweekly using the Borg scale (RPE ۹–۱۱). Data were analyzed using ANCOVA followed by Bonferroni post hoc test.Findings: WBT led to greater improvements in pain (ŋ² = ۰.۹۴), Y-Balance (ŋ² = ۰.۸۹), and functional disability (DASH; ŋ² = ۰.۳۱) compared to LBT (all p < ۰.۰۱). However, LBT showed superior proprioception with smaller joint position errors in internal rotation, external rotation, and abduction (all p < ۰.۰۵).Conclusion: WBT effectively reduces pain and disability and enhances stability, while LBT  improve proprioception, and combining both approaches may optimize overall rehabilitation and functional recovery in SIS.

کلیدواژه ها:

Pain ، proprioception ، swimmers ، Disability ، shoulder impingement syndrome