Celik Derya, Akyüz Gülseren, Yeldan Ipek
Department of Orthopedics and Traumatology, Istanbul Medicine Faculty of Istanbul University, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2009;43(6):504-9. doi: 10.3944/AOTT.2009.504.
We compared the effects of two different exercise programs below or above 90 degrees on pain in subacromial impingement syndrome (SIS).
Thirty patients (23 females, 7 males; mean age 52 years; range 34-70) with acute or subacute SIS were randomly assigned to two groups, equal in number, to receive an exercise program below (group 1) or above (group 2) 90 degrees , respectively. In addition to the standard exercise program, transcutaneous electrical nerve stimulation, intermittent ultrasound, and cold pack were applied, and a nonsteroidal anti-inflammatory drug was given. Treatment lasted two weeks (10 sessions). Pain was assessed using the Constant score, a visual analog scale (VAS), and face score, and psychologic state was assessed with the Beck Depression Inventory. Satisfaction levels of the patients and the therapist were measured. Assessments were made before, and 2 and 16 weeks after treatment.
Both groups had significant improvements in the Constant score, VAS score, and face score at 2 and 16 weeks. Change in the face score between 2 and 16 weeks was not significant in group 2. Improvements in the Beck Depression Inventory were significant in both groups. While patient satisfaction significantly increased in both groups, increase in the therapist's satisfaction between 2 and 16 weeks was significant only in group 1. The two groups did not differ with respect to changes in the Constant score, whereas VAS score at 2 weeks and face score at 16 weeks were significantly better in group 1. The two groups were similar with respect to improvements in the Beck Depression Inventory and patient/therapist satisfaction.
The exercise program below 90 degrees (pain-free range of motion) resulted in additional improvements in VAS and face scores in SIS.
我们比较了两种不同的运动方案（90度以下或90度以上）对肩峰下撞击综合征（SIS）疼痛的影响。
30例急性或亚急性SIS患者（23例女性，7例男性；平均年龄52岁；范围34 - 70岁）被随机分为两组，每组人数相等，分别接受90度以下（第1组）或90度以上（第2组）的运动方案。除标准运动方案外，还应用了经皮电神经刺激、间歇性超声和冷敷，并给予非甾体类抗炎药。治疗持续两周（10次疗程）。使用Constant评分、视觉模拟量表（VAS）和面部评分评估疼痛，并使用贝克抑郁量表评估心理状态。测量患者和治疗师的满意度。在治疗前、治疗后2周和16周进行评估。
两组在治疗后2周和16周时，Constant评分、VAS评分和面部评分均有显著改善。第2组在2周和16周之间面部评分的变化不显著。两组的贝克抑郁量表评分均有显著改善。两组患者满意度均显著提高，而治疗师的满意度在2周和16周之间仅第1组有显著提高。两组在Constant评分的变化方面无差异，而第1组在2周时的VAS评分和16周时的面部评分显著更好。两组在贝克抑郁量表评分改善以及患者/治疗师满意度方面相似。
90度以下（无痛活动范围）的运动方案在SIS患者的VAS和面部评分方面带来了额外的改善。
