scholarly journals The Effectiveness Of Routine Physiotherapy With And Without Neuromobilization In Patients With Shoulder Impingement Syndrome On Pain And Functional Disability; A Randomized Control Clinical Trial

2019 ◽  
Author(s):  
Muhammad Akhtar ◽  
Hossein Kirimi ◽  
Syed Amir Gilani ◽  
Ashfaq Ahmad ◽  
Asim Raza

Abstract Background: Neuromobilization (NM) includes neurophysiological parameters that vary between clinicians. This randomized controlled trial aimed to investigate the NM on the outcomes of participants with shoulder impingement syndrome (SIS) following treatment sessions (base line to follow up). Study design: Single blinded randomized control clinical trial. Methods: Patients (80) with shoulder impingement syndrome (SIS) were asked to participate in this trial. At the first session, participants were randomly assigned to either control group (40) or experimental group (40). After the baseline assessment routine physiotherapy was executed for both groups, while NM was provided to experimental group. Pain and functional disability score were evaluated on baseline, post treatment and after follow up. Pain was considered as primary out come and functional disability score as secondary outcome. Improvement was evaluated at post treatment and follow up. Differences in outcome between groups were evaluated with clinical improvement. Results: The experimental group compared with control group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% (CI), -2.38 to -1.25; P ˂ 0.001 and Partial ƞ2=0.33, similarly functional disability score 28.58(27.32-29.83) vs 20.10(18.84-21.36); between group difference ,5.62; 95%CI,(4.32-6.92); P˂ 0.001 and Partial ƞ2=0.49. Over all pain and functional disability score were improved among experimental group relative to control group at 11th week. Conclusion: In an experimental setting, the delivery of neuromobilization leads to significantly different outcomes in participants than in control group. Studies are still required to explore the mechanisms underlying neuromobilization effects. Trial registration: IRCT20190121042445N1, Registered 19 February 2019. Key words: shoulder impingement, neuromobilization, functional disability.

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Akhtar ◽  
Hossein Karimi ◽  
Syed Amir Gilani ◽  
Ashfaq Ahmad ◽  
Asim Raza

Abstract Background The objective of the study was to compare the effects of neuromobilization (NM) techniques and routine physiotherapy on pain and functional disability in patients having shoulder impingement syndrome (SIS). Present study was aimed to discover evidence based conservative and cost effective remedy on pain and functional disability. Study design Single blinded randomized control clinical trial. Methods A total of 80 patients with SIS were randomly assigned into care and experimental groups (40 in each group). After the baseline assessment routine physiotherapy was executed on both groups, while NM was applied additionally to experimental group. Pain and functional disability score were evaluated by Visual Analogue Scale and University of California at Los Angeles rating score at baseline, 5th and 11th week. Differences in outcome between groups were evaluated with clinical improvement. Results The experimental group compared with care group at 11th week had lower mean pain score 2.15(1.66–2.64) vs 4.90(4.41–5.40); between group difference, 1.82; 95% (CI), − 2.38 to − 1.25; P < 0.001 and Partial ƞ2 = 0.33, similarly functional disability score 28.58(27.32–29.83) vs 20.10(18.84–21.36); between group difference,5.62; 95%CI, (4.32–6.92); P< 0.001 and Partial ƞ2 = 0.49 respectively. In experimental group NM was a more effective technique to reduce the pain severity and disability in SIS patients as compare to care group. Conclusion Neuromobilization techniques in addition to routine physiotherapy were significantly effective for the treatment of SIS. Trial registration IRCT20190121042445N1, Registered 19 February 2019.


Author(s):  
Muhammad Akhtar Hunjra ◽  
Hossein Karimi ◽  
Syed Amir Gilani ◽  
Ashfaq Ahmad ◽  
Asim Raza

Abstract Objective: The purpose of this study was to evaluate the neuromobilization (NM) on the pain and active forward flexion of participants with shoulder impingement syndrome (SIS). Methods: A randomized control trial was conducted in Social Security Hospital, Gujranwala. The duration of study was September 2016 to March 2018. A sample of 80 participants was selected and allocated in to two groups using computer generator method in simple random sampling technique. Consent was taken from patients with SIS for this trial. At the first session, participants were randomly assigned to either control group (40) or experimental group (40). After the baseline assessment routine physiotherapy was executed for both groups, while NM was provided to experimental group. Pain and active forward flexion (AFF) were evaluated on baseline, 5th week and 11th week. The data were entered and analyzed using SPSS (version 22.0). Results: The experimental group compared with control group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% confidence interval (CI), -2.38 to -1.25; P ? 0.001 and Partial ?2=0.33, similarly with AFF 147.13(142.46-151.79) vs 123.45(118.79-128.11); between group difference ,19.35; 95% CI,(12.86-25.83); P ? 0.001 and Partial ?2=0.30. Over all pain and AFF were improved among experimental group relative to control group at 11th week. Conclusion: In an experimental setting, the delivery of neuromobilization led to significantly different outcomes in participants than in control group. Clinical Trial Number: IRCT20190121042445N1. Keywords:  shoulder impingement syndrome, pain, rotator cuff. Continuous...


2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0015
Author(s):  
Zeynep Hazar ◽  
Gul Baltacı

Objectives: The purpose of this study was to examine the effects of Throwers Ten (T10) exercise program on pain and function in patients with shoulder impingement syndrome. Methods: Twenty subjects who were assigned by random sampling to an experimental group (n=10) to which Throwers Ten (T10) exercise and a control group (n=10) to which ordinary physical treatment were applied. A 100 mm visual analogue scale (VAS) was used to evaluate the degree of pain. The Disability of Arm, Hand, and Shoulder (DASH) score was used to assess the functions of the upper extremity. To determine the range of motion, a universal goniometer was used to measure range of shoulder motion. Wilcoxon test was employed to examine differences in pain and function of the experimental group and the control group before and after the treatment. Results: There were significant differences in function and pain of the experimental group (p<0.05). The therapeutic effect in the experimental and control groups revealed significant differences in flexion, abduction, VAS and the DASH (p< 0.05); respectively. Conclusion: The results of this study suggest that Throwers Ten (T10) exercise would be positively affected pain alleviation and functional recovery in shoulder impingement patients.


2022 ◽  
Vol 8 (4) ◽  
pp. 248-252
Author(s):  
Zoya Khatoon Shamim Ahmed ◽  
Deepak B Anap

Kinesio-taping is widely used in sports rehabilitation for prevention and treatment of sports-related injuries. The role of Kinesio-taping has recently received renewed interest in patients with shoulder problems like shoulder impingement or rotator cuff tendinopathy.This pilot study was undertaken to check the effect of therapeutic kinesio-taping versus placebo kinesio-taping on shoulder pain, acromio-humeral distance (AHD), mobility and disability in patients with shoulder impingement syndrome.8 patients diagnosed with shoulder impingement syndrome were included in the study and they were allocated into the experimental and control group. The patients in experimental group received ultrasound therapy for 8 minutes followed by application of therapeutic kinesio-taping and in control group patients received ultrasound therapy for 8 minutes followed by application of placebo kinesio-taping. Outcome measure were pain intensity by NPRS, shoulder range of motion by goniometry, acromio-humeral distance (AHD) using ultrasonography and functional disability by SPADI assessed at baseline, immediate after taping application and 3 days post intervention. Data analyzed with Kruskal-Wallis H test and p value less than 0.05 consider as significant.Therapeutic kinesio-taping group showed significant change in AHD (p=0.04), pain.(p=0.0001), shoulder range of motion including abduction (p=0.04), internal rotation (p=0.001) and functional disability (0.04), whereas placebo kinesio-taping showed no significant improvement in outcomes. Therapeutic kinesio-taping found to be effective in increasing AHD, range of motion, decreasing pain and functional disability when compare with placebo kinesio-taping. It can be used as adjunct treatment option in patient with shoulder impingement.


2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Muhammad Akhtar ◽  
Hossein Kirimi ◽  
Syed Amir Gilani ◽  
Ashfaq Ahmad

Background & Objective: Routine physiotherapy has been advocated was an effective treatment for internal shoulder impingement syndrome. However, there is lack of best exercise treatment and lots of studies are under consideration. The objective of the study was to compare the effects of Neuromobilization and routine physiotherapy on pain in patients having shoulder internal impingement syndrome. Methods: This is a single blinded randomized control clinical trial that was conducted at Social Security Hospital Gujranwala in which 80 patients with SIS were participated. The duration of study was from September 2016 to March 2018. Patients were recruited after giving an informed consent and were randomly assigned to either control or experimental group which was treated with routine physiotherapy and routine physiotherapy plus neuromobilization respectively; pain was assessed by Numeric Rating Scale at base line, 5th and 11th week. Results: The experimental group compared with control group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% (CI), -2.38 to -1.25; P < 0.001 and Partial ŋ2=0.33. These results show that pain score is much improved in experimental group. Conclusion: Neuromobilization along with physical therapy is more effective as compared to physiotherapy alone. doi: https://doi.org/10.12669/pjms.36.4.1545 How to cite this:Akhtar M, Karimi H, Gilani SA, Ahmad A. Effects of routine physiotherapy with and without neuromobilization in the management of internal shoulder impingement syndrome: A randomized controlled trial. Pak J Med Sci. 2020;36(4):---------.  doi: https://doi.org/10.12669/pjms.36.4.1545 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
pp. 026921552097176
Author(s):  
Amir Letafatkar ◽  
Pouya Rabiei ◽  
Sarvenaz Kazempour ◽  
Samaneh Alaei-Parapari

Objective: To investigate if adding Kinesio tape to therapeutic exercise is an effective treatment to improve clinical outcomes compared to therapeutic exercise alone and no intervention, in patients with shoulder impingement syndrome. Design: Three-arm randomized controlled trial Setting: Outpatient setting Subjects: One hundred and twenty patients (mean (SD): age 37.8 (5.4)) with shoulder impingement syndrome. Intervention: Patients were randomly assigned to eight-weeks therapeutic exercise alone, therapeutic exercise with Kinesio tape, and control group. Main measures: Pain was measured with a numerical rating scale and disability and scapular kinematics were measured with a relative questionnaire and motion analysis software respectively, at baseline and after eight-weeks intervention. Results: There was significant differences in therapeutic exercise with Kinesio tape group vs. therapeutic exercise alone and control group respectively for pain ( d = –0.34, P = 0.042; and d = –1.53, P = 0.001), disability ( d = –0.46, P = 0.024; and d = –2.18, P = 0.001), scapular upward rotation at sagittal plane ( d = 0.33, P = 0.033; and d = 0.68, P = 0.001), scapular plane ( d = 0.18, P = 0.045; and d = 0.43, P = 0.001), scapular tilt at sagittal plane ( d = 0.55, P = 0.043; and d = 1.39, P = 0.001), and scapular plane ( d = 0.29, P = 0.034; and d = 0.58, P = 0.001). Therapeutic exercise alone was superior over control group in all significant outcomes ( P < 0.05). Conclusion: Although therapeutic exercises alone showed positive effect on clinical outcomes, adding Kinesio tape to therapeutic exercises had more significant effects with larger effect sizes. Adding Kinesio tape to therapeutic exercise may be of some assistance to clinicians in improving clinical outcomes in patients with shoulder impingement syndrome.


2006 ◽  
Vol 86 (8) ◽  
pp. 1075-1090 ◽  
Author(s):  
Philip W McClure ◽  
Lori A Michener ◽  
Andrew R Karduna

Abstract Background and Purpose. Several factors such as posture, muscle force, range of motion, and scapular dysfunction are commonly believed to contribute to shoulder impingement. The purpose of this study was to compare 3-dimensional scapular kinematics, shoulder range of motion, shoulder muscle force, and posture in subjects with and without primary shoulder impingement syndrome. Subjects. Forty-five subjects with impingement syndrome were recruited and compared with 45 subjects without known pathology or impairments matched by age, sex, and hand dominance. Methods. Shoulder motion and thoracic spine posture were measured goniometrically, and force was measured with a dynamometer. An electromagnetic motion analysis system was used to capture shoulder kinematics during active elevation in both the sagittal and scapular planes as well as during external rotation with the arm at 90 degrees of elevation in the frontal plane. Results. The impingement group demonstrated slightly greater scapular upward rotation and clavicular elevation during flexion and slightly greater scapular posterior tilt and clavicular retraction during scapular-plane elevation compared with the control group. The impingement group demonstrated less range of motion and force in all directions compared with the control group. There were no differences in resting posture between the groups. Discussion and Conclusion. The kinematic differences found in subjects with impingement may represent scapulothoracic compensatory strategies for glenohumeral weakness or motion loss. The decreased range of motion and force found in subjects with impingement support rehabilitation approaches that focus on strengthening and restoring flexibility.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mathias Bäck ◽  
Mika Paavola ◽  
Pasi Aronen ◽  
Teppo L. N. Järvinen ◽  
Simo Taimela ◽  
...  

Abstract Background Arthroscopic subacromial decompression is one of the most commonly performed shoulder surgeries in the world. It is performed to treat patients with suspected shoulder impingement syndrome, i.e., subacromial pain syndrome. Only few studies have specifically assessed return-to-work rates after subacromial decompression surgery. All existing evidence comes from open, unblinded study designs and this lack of blinding introduces the potential for bias. We assessed return to work and its predictors in patients with shoulder impingement syndrome in a secondary analysis of a placebo-surgery controlled trial. Methods One hundred eighty-four patients in a randomised trial had undergone arthroscopic subacromial decompression (n = 57), diagnostic arthroscopy, a placebo surgical intervention, (n = 59), or exercise therapy (n = 68). We assessed return to work, defined as having returned to work for at least two follow-up visits by the primary 24-month time point, work status at 24 and 60 months, and trajectories of return to work per follow-up time point. Patients and outcome assessors were blinded to the assignment regarding the arthroscopic subacromial decompression vs. diagnostic arthroscopy comparison. We assessed the treatment effect on the full analysis set as the difference between the groups in return-to-work rates and work status at 24 months and at 60 months using Chi-square test and the predictors of return to work with logistic regression analysis. Results There was no difference in the trajectories of return to work between the study groups. By 24 months, 50 of 57 patients (88%) had returned to work in the arthroscopic subacromial decompression group, while the respective figures were 52 of 59 (88%) in the diagnostic arthroscopy group and 61 of 68 (90%) in the exercise therapy group. No clinically relevant predictors of return to work were found. The proportion of patients at work was 80% (147/184) at 24 months and 73% (124/184) at 60 months, with no difference between the treatment groups (p-values 0.842 and 0.943, respectively). Conclusions Arthroscopic subacromial decompression provided no benefit over diagnostic arthroscopy or exercise therapy on return to work in patients with shoulder impingement syndrome. We did not find clinically relevant predictors of return to work either. Trial registration ClinicalTrials.gov identifier NCT00428870.


Sign in / Sign up

Export Citation Format

Share Document