Pekgöz Ferit, Taşkıran Hanifegül, Kaya Mutlu Ebru, Atalay Ayçe, Çeliker Reyhan
Division of Physical Therapy and Rehabilitation, Istanbul Medipol University, Institute of Health Sciences, Istanbul, Turkey.
Division of Physical Therapy and Rehabilitation, Istanbul Aydın University, Faculty of Health Sciences, Istanbul, Turkey.
Turk J Phys Med Rehabil. 2020 May 18;66(2):184-192. doi: 10.5606/tftrd.2020.3649. eCollection 2020 Jun.
This study aims to investigate the effects of joint mobilization with supervised exercise in patients with subacromial impingement syndrome (SAIS).
This prospective, randomized-controlled study included a total of 40 patients (18 males, 22 females; mean age 43.52 years; range, 27 to 67 years) with SAIS of more than six weeks between June 2014 and June 2015. The patients were randomly allocated into two groups: Group 1 (n=20) received joint mobilization and neuromuscular electrical stimulation and Group 2 (n=20) received a supervised exercise program and neuromuscular electrical stimulation. The outcome measures included the range of motion, pain intensity, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form-patient self-report section, Short Form-36, and Global Rating of Change Questionnaire. Pain was evaluated using the visual analog scale (VAS).
In both groups, the mean VAS scores significantly decreased and the range of motion significantly increased after treatment (p<0.05). Both joint mobilization and supervised exercise combined with neuromuscular electrical stimulation led to a significant improvement in function in patients with SAIS (p<0.05), although it did not significantly differ between the groups (p>0.05). Patient satisfaction with treatment was similar in both groups (p=0.28).
Based on our study results, mobilization and supervised exercise yield comparable outcomes in patients with SAIS.
本研究旨在探讨关节松动术联合监督下运动对肩峰下撞击综合征（SAIS）患者的影响。
本前瞻性随机对照研究纳入了2014年6月至2015年6月期间共40例SAIS病程超过六周的患者（男性18例，女性22例；平均年龄43.52岁；范围27至67岁）。患者被随机分为两组：第1组（n = 20）接受关节松动术和神经肌肉电刺激，第2组（n = 20）接受监督下的运动计划和神经肌肉电刺激。结局指标包括活动范围、疼痛强度、手臂、肩部和手部功能障碍（DASH）问卷、美国肩肘外科医师协会标准化肩部评估表 - 患者自我报告部分、简明健康状况调查量表（Short Form-36）以及总体变化评定问卷。使用视觉模拟量表（VAS）评估疼痛。
两组患者治疗后VAS平均评分均显著降低，活动范围均显著增加（p<0.05）。关节松动术和监督下运动联合神经肌肉电刺激均使SAIS患者的功能得到显著改善（p<0.05），尽管两组之间差异无统计学意义（p>0.05）。两组患者对治疗的满意度相似（p = 0.28）。
基于我们的研究结果，关节松动术和监督下运动对SAIS患者产生的效果相当。
