Effect Of Hydrocortisone Phonophoresis Versus Iontophoresis In Patients With Subacromial Impingement Syndrome

Not Applicable

Recruiting

• Conditions: Impingement Syndrome; Subacromial Impingement Syndrome
• Interventions: Other: Therapeutic exercise; Other: hydrocortisone iontophoresis; Other: hydrocortisone phonophoresis

• Registration Number: NCT05919121
• Lead Sponsor: Horus University

Brief Summary

The purpose of this study will be to compare the efficacy of adding hydrocortisone phonophoresis or iontophoresis on pain, function, range of motion and shoulder external rotation isometric strength in patients with subacromial impingement syndrome.

Detailed Description

Routine physiotherapy has been advocated was an effective treatment for SIS. However, there is lack of best exercise treatment and lots of studies are under consideration. According to published data focused on management of shoulder pain, it looks like that therapeutic exercise is not sufficient to treat SIS and it is compulsory to combine with other remedies to get the best results

Study Timeline

• Study Start: 2023-05-01
• Status Verified: 2023-06
• Study First Submitted: 2023-06-14
• Study First Submitted QC: 2023-06-22
• Last Update Submitted: 2023-06-22
• Study First Posted: 2023-06-26
• Last Update Posted: 2023-06-26
• Primary Completion: 2023-08-15
• Study Completion: 2023-09-15

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

1. All patients were diagnosed as unilateral SIS with stage II Neer classification > 3 months.
2. Positive impingement sign (Neer's test or Hawkins-Kennedy test), / painful arc during active arm elevation, pain or weakness with resisted isometric external rotation or resisted scapular plane abduction with the humeral internal rotation (empty can test)
3. The age of patients ranged from 18 - 60 years old.
4. Both genders will be involved.
5. Shoulder pain scores more than 5 on a numeric rate scale for pain of 0- 10.
6. Failure to respond to conservative NSAID.

Exclusion Criteria

1. Frozen shoulders.
2. Arthritis of the shoulder.
3. Shoulder instability.
4. Pregnant women.
5. A pacemaker.
6. Previous shoulder surgery.
7. History of dislocation of the shoulder.
8. Internal metallic fixation.
9. Malignancy.
10. Previous corticosteroid injection.
11. Rheumatoid arthritis
12. Partial or Full thickness tear of the rotator cuff.
13. Cervical radiculopathy.
14. Physiotherapeutic shoulder treatment within the last 3 months.
15. The patients will randomly be assigned into 3 equal groups, 20 patients for each group.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Therapeutic exercise group	Therapeutic exercise	Therapeutic exercise group, group A.
hydrocortisone iontophoresis group	hydrocortisone iontophoresis	This group (C) will receive the same exercise program in addition to hydrocortisone iontophoresis.
hydrocortisone phonophoresis group	hydrocortisone phonophoresis	This group (B) will receive the same exercise program in addition to hydrocortisone phonophoresis. Patients will receive topical medium phonophoresis of 10% hydrocortisone gel.
hydrocortisone iontophoresis group	Therapeutic exercise	This group (C) will receive the same exercise program in addition to hydrocortisone iontophoresis.
hydrocortisone phonophoresis group	Therapeutic exercise	This group (B) will receive the same exercise program in addition to hydrocortisone phonophoresis. Patients will receive topical medium phonophoresis of 10% hydrocortisone gel.

Primary Outcome Measures

Name	Time	Method
Assessing the change in isometric shoulder strength	at baseline and after 6 weeks of intervention	A handheld Lafayette dynamometer will be used to evaluate the peak shoulder External Rotation muscles isometric strength
Assessing the change in shoulder Range Of Motion	at baseline and after 6 weeks of intervention	In this study shoulder ROM will be measured by using Electrogoniometer (flexion, abduction and internal rotation ranges will be measured in degrees), which eliminates the need to manually score each measurement.
Assessing the change in Shoulder Pain and Disability	at baseline and after 6 weeks of intervention	By using Shoulder Pain and Disability Index (SPADI). SPADI has been found to be the quickest (within five minutes) and easiest to complete, as well as being more responsive to change. The SPADI is considered to be, by comparison, one of the most useful instruments about the shoulder joint, and has been tested in various clinical settings. The SPADI is a 13-item shoulder function index on the ability of responders to carry out basic activities of daily living. Each item is scored by a numeric rating scale that ranges from 0 (no pain/no difficulty) to 10 (worst pain imaginable/so difficult it required help).

Trial Locations

Locations (1)

Outpatient clinic faculty of physical therapy, horus university, egypt; 🇪🇬 Damieta, Egypt