Abstract
PURPOSE: The purpose of this study was to compare the effect of graded physiotherapeutic training of the rotator cuff versus soft tissue mobilization in patients with shoulder impingement syndrome with a 2-year follow-up. METHODS: Forty-six consecutive patients aged 30 and 55 years were enrolled in this study that had supraspinatus tendonitis and/or partial supraspinatus rupture (Stage 1). Patients were randomly separated into three groups (Group1: 49.3 y, Group2: 49.7 y, Group3: 48.0 y) and had following treatments: Group 1: Ice application+ exercise+ joint and soft tissue mobilization (n: 19), Group 2: Ice application+ exercise with supervision (n: 14), Group 3: Ice application and home exercise programme (n: 13). The patients were encouraged to continue to do active exercises at home on a daily basis. Group I and II took rehabilitation programme in a university sports physiotherapy clinic, 3 times per week for 3 weeks. Patients were evaluated on the 12th week following rehabilitation and pain (at night, during motion, at rest), ROM, isokinetic testing, impingement tests (Neer and Hawkins), tendon tests, UCLA and MASES also measured in the second year after intervention RESULTS: There was statistically a significant difference within groups as 1 and 3 at night pain at 12th-week and 2 year follow-up; respectively (p<0.05). Activity pain in Group 3 was found statistically difference between 12th-week and 2 year follow-up (p<0.05). There were no statistically differences among groups for Neer, Hawkins and Supraspinatus tendon tests; and MASES between 12th week and 2 year-follow-up (p>0.05). UCLA results were found statistically differences within Group 2 and 3 (p<0.05). ROM of external rotation in the left side between Group 1 and 2 was statistically different at 12th week and 2 year follow-up. ROM of flexion in the left side between Group 2 and 3 was statistically different at the 12th week (p<0.05). CONCLUSIONS: This study showed that manipulative therapy in patients with impingement syndrome might improve the increased shoulder function and decreased pain than traditional physiotherapy. Patients who attending to regular exercise program at clinic were improved the better results than the patients at home-group in the long-term.
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