The effectiveness of routine physiotherapy with and without neuromobilization in patients with shoulder impingement syndrome.

Muhammad Akhtar Hunjra Muhammad Akhtar Hunjra,Syed Amir Gilani Syed Amir Gilani,Hossein Karimi Hossein Karimi,Asim Raza Asim Raza,Ashfaq Ahmad Ashfaq Ahmad

doi:10.47391/jpma.918

Muhammad Akhtar Hunjra Muhammad Akhtar Hunjra, Syed Amir Gilani Syed Amir Gilani + Show 3 more

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https://doi.org/10.47391/jpma.918

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Abstract

The purpose of this study was to evaluate the effectiveness of neuromobilization (NM) on the pain and active forward flexion in participants with shoulder impingement syndrome (SIS). A randomized control trial was conducted in Social Security Hospital, Gujranwala. The duration of study was September 2016 to March 2018. A sample of 80 participants was selected and allocated in to two groups using computer generator method in simple random sampling technique. Consent was taken from patients with SIS for this trial. At the first session, participants were randomly assigned to either control group (n=40) or experimental group (n=40). After the baseline assessment routine physiotherapy was executed for both groups, while NM was provided to experimental group. Pain and active forward flexion (AFF) were evaluated at baseline, 5th week and 11th week. The data were entered and analyzed using SPSS (version 22.0). The experimental group compared with control group at 11th week had lower mean pain score 2.15 (1.66-2.64) vs 4.90 (4.41-5.40); between group difference, 1.82; 95% confidence interval (CI), -2.38 to -1.25; P ˂0.001 and Partial ƞ2=0.33, similarly with AFF 147.13 (142.46-151.79) vs 123.45(118.79-128.11); between group difference ,19.35; 95% CI, (12.86-25.83); P ˂ 0.001 and Partial ƞ2=0.30. Over all pain and AFF were improved among experimental group relative to control group at 11th week. In an experimental setting, the delivery of neuromobilization led to significantly different outcomes in participants of SIS than in control group.

Highlights

Shoulder pain is a common problem among patients seeking medical attention.Correct diagnosis and therapy might be difficult due to the variety of disorders.Differential diagnosis considerations of shoulder pain include cervical radioculopathy, rotator cuff tears, bicipital tenosynovitis and shoulder impingement syndrome (SIS) (1).SIS consists of rotator cuff tendonitis and bursitis of shoulder (2)
The experimental group compared with control group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% confidence interval (CI), -2.38 to -1.25; P 0.001 and Partial ƞ2=0.33, with active forward flexion (AFF) 147.13(142.46-151.79) vs 123.45(118.79
Over all pain and AFF were improved among experimental group relative to control group at 11th week

Summary

Introduction

Shoulder pain is a common problem among patients seeking medical attention.Correct diagnosis and therapy might be difficult due to the variety of disorders.Differential diagnosis considerations of shoulder pain include cervical radioculopathy, rotator cuff tears, bicipital tenosynovitis and shoulder impingement syndrome (SIS) (1).SIS consists of rotator cuff tendonitis and bursitis of shoulder (2). Shoulder pain is a common problem among patients seeking medical attention. Correct diagnosis and therapy might be difficult due to the variety of disorders. Differential diagnosis considerations of shoulder pain include cervical radioculopathy, rotator cuff tears, bicipital tenosynovitis and shoulder impingement syndrome (SIS) (1). SIS consists of rotator cuff tendonitis and bursitis of shoulder (2). The SIS involves inflammation of supraspinatus tendon between anteroinferior junction of acromion and greater tuberosity of humerus. SIS is categorized by severe pain that increases during overhead activities and at night sleeping on affected side(3)

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