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)
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