PNF in Subacromial Impingement Syndrome

Ankara Yildirim Beyazıt University

Status: Completed

Conditions: Subacromial Impingement Syndrome

Treatments: Other: CT+ PNF in extremity pattern; Other: CT+ PNF in extremity pattern+PNF in scapula and upper trunk patterns; Other: Conventional therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT04794933

2015

Details and patient eligibility

About

Although proprioceptive neuromuscular facilitation (PNF) techniques have been used in the treatment of different shoulder problems, PNF techniques in scapular and upper trunk patterns with extremity pattern have not been considered as a possible option for the treatment of Subacromial Impingement Syndrome (SIS). The aim of this study was to evaluate the effects of different PNF patterns in SIS.

Full description

This randomized controlled trial was conducted in the Outpatient Clinic of a Physiotherapy and Rehabilitation Department in Ankara, Turkey. The demographic and clinical characteristics of the patients were recorded. Voluntary patients with SIS were regarded as eligible for the study if they met the inclusion criteria. Pain, posture and functionality were assessed before and after intervention. Patients who met the inclusion criteria and agreed to participate were randomly allocated to Group 1 [Conventional therapy (CT)], Group 2 [CT+ PNF in extremity pattern] and Group 3 [CT+ PNF in extremity pattern+PNF in scapula and upper trunk patterns]. A simple randomization method was used with opaque sealed envelopes containing "A", "B" or "C". Group allocation was performed by an independent therapist, not involved in the study. All patients received physiotherapy for approximately 60 mins each session, 3 sessions per week for 6 weeks. Conventional therapy consisted of cold pack (15 minutes); pulsed ultrasound therapy (1 watt/cm², 3 MHz, 1:2 pulsed mode; 3 minutes); transcutaneous electrical nerve stimulation (60-120 Hz; 20 minutes) and exercises (20 minutes). The exercises included stretching, strengthening and posture exercises. The exercises, and the duration and intensity of conventional physiotherapy were selected according to previous studies which showed that a physiotherapy program 3 times a week for 6 weeks was effective in improving function and relieving pain in SIS. The physiotherapy program was applied to all patients at the same intensity by the same physiotherapist and patients did the exercises every day throughout the 6-week period. The patients were also advised to avoid overhead activities.

Enrollment: 45 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients diagnosed with SIS,
• aged between 18 and 65 years,
• shoulder pain ongoing for more than four weeks,
• loss of active shoulder motion or painful ROM,
• no treatment related to the shoulder in the last 6 months.

Exclusion criteria

• history of frozen shoulder,
• disorders of the acromioclavicular joint,
• possession of a curved or hooked acromion,
• shoulder instability,
• degenerative arthritis of the glenohumeral joint,
• calcifying tendonitis,
• post-traumatic disorders,
• shoulder surgery and/or elbow, hand, wrist and cervical spine disorders,
• diseases that can cause positional vertigo.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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45 participants in 3 patient groups

Conventional therapy (CT)

Active Comparator group

Description:

Cold pack (15 minutes); pulsed ultrasound therapy (1 watt/cm², 3 MHz, 1:2 pulsed mode; 3 minutes); transcutaneous electrical nerve stimulation (60-120 Hz; 20 minutes) and exercises (20 minutes). The exercises included stretching, strengthening and posture exercises.

Treatment:

Other: Conventional therapy

CT+ PNF in extremity pattern

Experimental group

Description:

PNF in the extremity pattern, were instructed to actively move through the PNF flexion-abduction-external rotation diagonal pattern for 10 repetitions with manual facilitation and the treatment was performed within the range in which pain did not occur. Rhythmic stabilization and repeated contractions were applied from the PNF techniques.

Treatment:

Other: CT+ PNF in extremity pattern

Other: Conventional therapy

CT+ PNF in extremity pattern+PNF in scapula and upper trunk patterns

Experimental group

Description:

PNF in scapula and upper trunk patterns in addition to PNF in the extremity pattern. The scapular pattern application was performed by positioning the affected extremity in a relaxed position above the stable side in the side-lying position. Rhythmic stabilization and repeated contractions were applied from the anterior-elevation position in the direction of posterior-depression. Extension, lateral flexion and rotation to the affected side were performed in the trunk patterns in rhythmic stabilization and repeated contractions.

Treatment:

Other: CT+ PNF in extremity pattern+PNF in scapula and upper trunk patterns

Other: CT+ PNF in extremity pattern

Other: Conventional therapy