THE EFFECT OF MANUAL THERAPY IN THE CONSERVATIVE MANAGEMENT OF IMPINGEMENT SYNDROME IN SHOULDER
Gül BALTACI, Ayşenur BEŞLER, Volga BAYRAKÇITUNAY, Nevin ERGUN
Hacettepe Üniversitesi Fizik Tedavi ve Rehabilitasyon Yüksekokulu Spor Fizyoterapisi Ünitesi
Keywords: Shoulder, Impingement Syndrome, Manual Therapy.
Introduction: Although there have been great advances in the treatment of impingement syndromes in shoulder at last years, the advantages and disadvantages of various treatment methods have led to a lack of consensus on this subject. The appropriate treatment method is of great importance for keeping pain-free and active functional levels of patients during vocational or/ and athletic activities as soon as possible.
Patients and methods: Forty-eight patients with impingement syndromes in shoulder were treated with three different types of conservative management at the Sports Physiotherapy Unit of School of Physiotherapy and Rehabilitation at Hacettepe University between 1.1.1993-31.5.2000. Average age was 37.5 (19-53). All of the patients had their symptoms and Grade 1 according to magnetic resonance imaging. 16 patients (Group A) were treated with traditional physiotherapy techniques, 16 patients (Group B) with manual therapy additional to traditional physiotherapy and 16 patients (Group C) with only manual therapy. Average follow-up period was 3 weeks for all patients. Pain, daily living activities and function were rated on a ten-point scale (with ten being best) at rest, at night, and during activities.
Results: When compared with the results of the study, there was a significant difference in the decrease of pain (p<0.05), the increase of range of motion (p<0.05), and the short-term of treatment (p<0.05) in patients with Group C as compared with patients with Group A. There was no significant difference between Group B and Group C about pain and range of motion (p>0.05) in spite of the significant difference about treatment duration of patients with Group C.
Conclusion: For early function in daily living and/ or athletic activities in shoulder and successful clinical outcomes in short-term by taking into consideration the expected treatment duration in patients with impingement syndrome Grade I manual therapy must be the primary choice for management.