Comparison of the Proprioceptive Neuromuscular Facilitation and Mobilization In Subacromial Impingement Syndrome

Not Applicable

Completed

• Conditions: Subacromial Impingement Syndrome; Subacromial Impingement
• Interventions: Other: Conventional Physiotherapy; Other: Shoulder Mobilization; Other: Proprioceptive Neuromuscular Facilitation

• Registration Number: NCT03735485
• Lead Sponsor: Sevgi Medical Center

Brief Summary

Aim of the study was to compare the effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) exercises and Shoulder Mobilization (SM) on pain, range of motion (ROM), functionality, and muscle strength in patients with Subacromial Impingement Syndrome (SIS). Patients received 20 sessions (for 4 weeks) under the supervision of a physiotherapist. Patients were evaluated at baseline, at week two, at week four, and at week sixteen.

Detailed Description

Aim of the study was to compare the effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) exercises and Shoulder Mobilization (SM) on pain, range of motion (ROM), functionality, and muscle strength in patients with Subacromial Impingement Syndrome (SIS). Forty-four patients were divided into three groups as Group I: Conventional physiotherapy receiving group (control group; n=14), Group II: Conventional physiotherapy + PNF exercises receiving group (PNF group; n=15), and Group III: conventional physiotherapy + SM receiving group (SM group; n=15). Pain, ROM, muscle strength, and functionality were evaluated by using visual analog scale (VAS), goniometer, push-pull dynamometer, Constant-Murley score and The Disabilities of the Arm, Shoulder and Hand (DASH) Score respectively. Patients received 20 sessions in total under supervision of a physiotherapist. Patients were evaluated at baseline, at week two, at week four, and at week sixteen.

Study Timeline

• Study Start: 2017-03-03
• Primary Completion: 2017-10-02
• Study Completion: 2018-01-10
• Status Verified: 2018-11
• Study First Submitted: 2018-11-02
• Study First Submitted QC: 2018-11-07
• Last Update Submitted: 2018-11-07
• Study First Posted: 2018-11-08
• Last Update Posted: 2018-11-08

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 44

Inclusion Criteria

• Aged between 25-65 years old,
• Having the diagnosis of Subacromial Impingement Syndrome (SIS),
• Having shoulder pain at least for four weeks

Exclusion Criteria

• Having a neuromuscular disease,
• Pregnancy,
• History of cancer,
• Unstable angina,
• Having pulmonary and/or vascular problems,
• History of surgery at neck, shoulder, elbow or/and hand,
• Having communication problems
• Having systemic anti-inflammatory joint diseases
• Being contraindicated for electrical stimulation and/or exercise
• Having cervical disc herniation or radiculopathy
• History of physiotherapy on the same shoulder due to SIS,
• A history of corticosteroid injection in the last three months,
• Any orthopedic, rheumatologic, or congenital condition that effects the targeted shoulder

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
Group III	Conventional Physiotherapy	The Proprioceptive Neuromuscular Facilitation (PNF) group. Participants in this group received conventional physiotherapy and PNF exercises. Number of the participants were 15.
Group I	Conventional Physiotherapy	The control group. Participants in this group received only conventional physiotherapy. Number of the participants were 14.
Group II	Shoulder Mobilization	The shoulder mobilization group. Participants in this group received conventional physiotherapy and shoulder joint mobilization techniques. Number of the participants were 15.
Group III	Proprioceptive Neuromuscular Facilitation	The Proprioceptive Neuromuscular Facilitation (PNF) group. Participants in this group received conventional physiotherapy and PNF exercises. Number of the participants were 15.
Group II	Conventional Physiotherapy	The shoulder mobilization group. Participants in this group received conventional physiotherapy and shoulder joint mobilization techniques. Number of the participants were 15.

Primary Outcome Measures

Name	Time	Method
Shoulder pain: VAS	Change from baseline pain scale of shoulder at week 2, 4 and 16.	Pain was defined with Visual Analog Scale (VAS). A 10-cm long horizontal visual analog scale (VAS) with marks 0 point (no pain) and 10 point (unbearable pain) was used for evaluating the pain severity. The patients were asked to mark the representing point of their pain levels. The values were recorded in cm. The pain severity was asked in three occasions as: at resting (VASr), during activity (VASa) and during night (VASn).
Range of motion	Change from baseline active range of motion at week 2, 4 and 16.	The active range of motion was assessed by using a universal goniometer.
Disability of the shoulder	Change from baseline Disabilities of the Arm, Shoulder and Hand (DASH) Score at week 2, 4 and 16.	The Disabilities of the Arm, Shoulder and Hand (DASH) Score was used to evaluate the upper extremity physical function. DASH includes two modules as disability / symptom section and work section. The scores are ranged between 0-100. Higher scores indicate lower functionality.
Function of the shoulder	Change from baseline Constant-Murley score at week 2, 4 and 16.	In addition to DASH, the Constant-Murley score was used to evaluate the functionality of the shoulder. Constant-Murley score is a 100-point scoring system and consisted of four sub-scores as pain (15 points), daily living activities (20 points), active range of motion (40 points), and muscle strength (25 points).
Muscle Strength	Change from baseline muscle strength of shoulder flexion, shoulder abduction, shoulder adduction, shoulder external rotation, and shoulder internal rotation at week 2, 4 and 16.	The muscle strength of shoulder flexion, shoulder abduction, shoulder adduction, shoulder external rotation, and shoulder internal rotation were determined by using Baseline Push-Pull (New York, USA) dynamometer. The dynamometer was placed in a 90 degrees angle on the location and the patient was asked to contract in maximum for two seconds and then maintain this position for five seconds. Two assessments were performed, and average values were recorded. Pain was avoided during the measurements.

Trial Locations

Locations (1)

Sevgi Medical Center; 🇹🇷 Istanbul, Arnavutkoy, Turkey