1. Isometric Contractions Combined wiceth Ecntric Contractions and Stretching Exercises on Patient with Subacromial Impingement Syndrome. Efstratiadis Anastasios 1, Mamais Ioannis 2 & Stasinopoulos Dimitrios 3 Background Subacromial impingement syndrome (SIS) is an umbrella term, encloses many pathological causes, such as rotator cuff tendinopathy, long head of the biceps tendinopathy, subacromial bursitis [1]. SIS is cause of ill-health of 2-8% population workers [2].Shoulder pain occurs for patients at all ages and at all activity levels [3]. SIS appears in all the patients with a percentage of 44-60% suffering from shoulder pain in primary care [4, 5]. The main symptoms, often described by patients, are pain in the shoulder joint, shoulder dyskinesia, difficulty in the upper activities and muscle weakness [6].Objectives The aim of this case study was found the effectiveness of the program exercises combination, which was stretching, isometric and eccentric contraction.Methods A patient with SIS for 1 year was included in present case report. The patient was followed an supervised exercise program, which was stretching exercises, isometric contraction and eccentric exercises, for muscle muscles of the rotator cuff four times per week for four weeks. Patient was evaluated at the baseline (0 week) and at the end of the program exercises (4 weeks). Pain, pain rest, pain activity and pain night was measured on a visual analogue scale (VAS), were 0 (cm) was none pain and 10 (cm) was the largest pain. Disability was measured on Disabilities of the Arm, Shoulder and Hand (DASH scale). Range of motion was measured with goniometer (º) and pain at the end range of motionwas measured on a VAS. Conclusion The exercise program showed significant improvement in subacromial impingement syndrome, in reduced the pain, function and range of motion. However, this study showed efficacy in these exercises in short term (4weeks). All studies showed significant improvement, but must there is caution in dosage exercises, the ability depending of each patient and in stage where are. References 1.Marzetti, E, Rabini, A, Piccinini, G,Piazzini, DB, Vulpiani, MC, Vetrano, M, Specchia, A, Ferriero, G, Bertolini, C and Saraceni, VM. 2014. Neurocognitive therapeutic execise improves pain and function in patients with shoulder impingement syndrome: a single- blind randomized controlled clinical trial. European Journal of Physical and Rehabilitation Medicine;50(3):pp.255-64. 2.Svendsen, SW, Christiansen, DH, Haahr, JP, Andrea, LC and Frost, P. 2014. Shoulder function and work disability after decompression surgery for subacromial impingement syndrome: a randomized controlled trial of physiotherapy exercises and occupational medical assistance. BioMedCentral; pp.15:215. 3.Koester, MC, George, MS and Kuhn, JE. 2005 Shoulder impingent syndrome: review. The American Journal of Medicine; 118:pp.452-455. 4.Chipchase, LS, O’Connor, DA, Costi, JJ and Krishnan, J. 2009. Shoulder impingement syndrome: preoperative health status. Journal Shoulder Elbow Surgery;9:pp.12-15. 5.Nygren, A, Berglund, A, von Koch, M. 1995. Neck-and-shoulder pain, an increasing problem. Strategies for using insurance material to follow trends. Scand J Rehabil Med Suppl; 32: 107-112. 6.Camargo, PR, Avila, MA, Alburqueerque-Sendin, F, Asso, NA, Hashimoto, LH and Salvini, TF. 2012. Eccentric training for shoulder abductors improves pain, function and isokinetic performance in subjects with shoulder impingement syndrome: a case series. RevistaBrasileira de Fisiotherapia; 16(1): pp.74-83. Results In the baseline evaluation the pain was 5, pain rest was 4, pain activity was 8, pain night was 4 (Table 1), disability was 25.833 (Table 2), range of motion (Table 3) in flexion was 130º and pain at the end range flexion was 7, extension was 35º and pain was 3. Adduction was 60º and pain 5, abduction was 82º and pain 8, external rotation was 21º and pain 6 and internal rotation was 25º and pain 4. At the fourth week evaluation the pain was 2, pain rest was 2, pain activity was 3 and pain night was 1. Disability was 4.17, range of motion, flexion was 142º and pain 3, extension was 41º and pain 1, adduction was 73º and pain 3, abduction was 93º and pain 3, external rotation was 31º and pain was 2 and internal rotation was 38º and pain was 2. Table 3. Evaluation pain and disability (0-4 weeks). Table 1. Exercise program. 1Physiotherapist, student MSP Sports Physiotherapy, e-mail: tasose@hotmail.com,tasose@hotmail.com 2Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, e-mail: mamais@ucy.ac.cy 3Physiotherapy Program, Department of Health Sciences, School of Sciences, European University Cyprus, Director of Director of Cyprus Musculoskeletal and Sports Trauma Research Centre (CYMUSTREC), Nicosia, e-mail: D.Stassinopoulos@euc.ac.cy mamais@ucy.ac.cy D.Stassinopoulos@euc.ac.cy Table 2. Evaluation of range of motion and pain in the end of range (0-4 weeks).