Karaaslan Yasemin, Sahbaz Yasemin, Dogan Dildade Dilek, Ziroglu Nezih, Altun Süleyman, Mutlu Ebru Kaya
From the Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Hatay Mustafa Kemal University, Hatay, Turkey (YK); Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Beykent University, Istanbul, Turkey (YS); Department of Orthopedics and Traumatology, Istanbul Sile State Hospital, Istanbul, Turkey (DDD); Department of Orthopedics and Traumatology, Beylikduzu State Hospital, Istanbul, Turkey (NZ); Department of Orthopaedics and Traumatology, Bakırkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey (SA); and Department of Physical Therapy and Rehabilitation, Health Sciences Faculty, Bandirma Onyedi Eylul University, Bandirma, Turkey (EKM).
Am J Phys Med Rehabil. 2023 May 1;102(5):396-403. doi: 10.1097/PHM.0000000000002103. Epub 2022 Sep 12.
The aim of the study is to compare the effects of exercise training plus neuromuscular electrical stimulation with exercise training alone on shoulder function, pain, range of motion, and muscle strength in patients with subacromial impingement syndrome.
Patients were randomly divided into groups of exercise training ( n = 24) and exercise training + neuromuscular electrical stimulation ( n = 24). Shoulder function was evaluated with the Disabilities of the Arm, Shoulder and Hand Questionnaire, pain level was assessed with a visual analog scale, range of motion was measured with a goniometer, and muscle strength was assessed with a handheld dynamometer baseline and at the end of treatment (week 8).
In both groups, shoulder function, range of motion, and muscle strength (except flexion muscle strength in the exercise training group) increased, while pain decreased ( P < 0.05). Compared with the exercise training group, visual analog scale-activity and visual analog scale-night decreased more, and external-rotation range of motion and whole muscle strength increased more in the exercise training + neuromuscular electrical stimulation group ( P < 0.05). On the other hand, the effect sizes were medium to large for both groups.
The addition of neuromuscular electrical stimulation treatment to exercise training did not improve shoulder function, which is the primary outcome, more than exercise training alone, but increased muscle strength and range of motion (external-rotation only) and decreased pain (activity-night), which are the secondary outcomes.
本研究旨在比较运动训练加神经肌肉电刺激与单纯运动训练对肩峰下撞击综合征患者肩部功能、疼痛、活动范围和肌肉力量的影响。
将患者随机分为运动训练组（n = 24）和运动训练+神经肌肉电刺激组（n = 24）。采用手臂、肩部和手部功能障碍问卷评估肩部功能，用视觉模拟量表评估疼痛程度，用角度计测量活动范围，并用手持测力计在基线和治疗结束时（第8周）评估肌肉力量。
两组患者的肩部功能、活动范围和肌肉力量（运动训练组的屈曲肌肉力量除外）均有所增加，疼痛减轻（P < 0.05）。与运动训练组相比，运动训练+神经肌肉电刺激组的视觉模拟量表-活动和视觉模拟量表-夜间评分下降更多，外旋活动范围和整体肌肉力量增加更多（P < 0.05）。另一方面，两组的效应大小均为中等至较大。
在运动训练中添加神经肌肉电刺激治疗，在主要结局指标肩部功能方面，并不比单纯运动训练改善得更多，但在次要结局指标肌肉力量和活动范围（仅外旋）方面有所增加，疼痛（活动-夜间）有所减轻。
