Comparison of different electrotherapy methods and exercise therapy in shoulder impingement syndrome: A prospective randomized controlled trial. (2018)

PICO

Patient/Population

Aged between 18 and 55, with shoulder pain at least for four weeks and diagnostic of SIS with clinical examinations and MRIs. (n=83)

Intervention

  • Hot pack +Exercise
  • Ultrasound +Hp+exer.
  • Interferential current +Hp+exer.
  • TENS+Hp+exer.

Comparison

  • Hot pack +Exercise
  • Ultrasound +Hp+exer.
  • Interferential current +Hp+exer.
  • TENS+Hp+exer.

Outcomes

  • Pain

  • Quality of life

  • Shoulder function

Translatability:   (2/3) Medium                                     

Comments: Ultrasound, interferential current, and TENS in addition to hot pack and exercise had similar improvements in terms of pain, function, and physical component of quality of life. However, interferential current showed significantly better outcomes for the mental component of quality of life.
Limitations: Affected sides in patients were different; VAS scores at rest were different before treatment, where Group 3 had the lowest score; no statistically significant difference was observed in Group 3 after the treatment; although the patients were told to carry on with their exercises after treatment, they could not properly follow up on the patients in their homes, thus, it could not conclude from the results based on exercise continuum after the supervised program; only used three different electrotherapeutic methods with the same machine; no placebo application; a control group with no treatment could not be used due to ethical issues. Incomplete data on TENS, IC, and US technic of application, and also TENS parameters.

Appraisals:

PEDro Scale  – (5/10)  Concealed allocation: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Intention-to-treat analysis: No. (by PEDro – confirmed)

Evidence  – Level I (by the authors)

Metrics and
Journal Details:
scite_ report – 

 SCOPUS CiteScore View  / Resurchify Impact Score View 

BTB

Intervention – 1

  • Hot pack
  • Exercise

Dose

  •  15mn
  •  –

Periodicity

  • 3 times a week for 4 weeks

  • plus everyday home exercise 

Local/Technic:

  • Upper trapezius muscle
  • The exercise program, under the supervision of an experienced physiotherapist, and adjusted according to the patient’s tolerance, included Wand exercises for shoulder abduction, flexion, hyperextension and internal and external rotation, Codman exercises and isometric and resistive exercises of the shoulder girdle. Patients were encouraged to exercise at home on daily basis. The isometric exercises were used during the painful period, and the resistance exercises were added after the pain began to relieve

    Intervention – 2

    • Interferential current

    Dose

    •  20 min.

    Periodicity

    • 3 times afor 4 weeks

    Local/Technic:

    Around the shoulder, 50-120 Hz frequency.

      Intervention – 3

      • Conventional TENS

      Dose

      • 20 min.

      Periodicity

      • 3 times a week for 4 weeks

      Local/Technic:

        Intervention – 4

        • Ultrasound

        Dose

          • 1.5 W/cm² – 5min.

          Periodicity

          • 3 times a week for 4 weeks

          Local/Technic:

          • 1MHz

          Citation: Gunay Ucurum, S., Kaya, D. O., Kayali, Y., Askin, A., & Tekindal, M. A. (2018). Comparison of different electrotherapy methods and exercise therapy in shoulder impingement syndrome: A prospective randomized controlled trial. Acta orthopaedica et traumatologica turcica,52(4), 249–255. https://doi.org/10.1016/j.aott.2018.03.005

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