Subakromial sıkışma sendromu olan hastalarda terapotik ultrason tedavisinin etkinliği üzerine yapılan randomize kontrollü bir çalışma

Abstract

Amaç: Subakromial sıkışma sendromlu hastalarda terapotik ultrason tedavisinin eklem hareket açıklığı, ağrı, fonksiyonel testler ve yaşam kalitesi üzerine etkinliğinin değerlendirilmesi amaçlandı.Materyal Metod: Subakromial sıkışma sendromu tanısı alan 62 hasta çalışmaya alındı. Hastalar randomize edilerek iki gruba ayrıldı. Bir gruba standart egzersiz programı ve terapotik ultrason (n=31) ve diğer gruba standart egzersiz programı ve plasebo ultrason (n=31) verildi. Hastalar 12 hafta boyunca izlendi. Hastaların omuz eklem hareket açıklığı (EHA) goniometre ile, istirahat, gece ve hareketle oluşan omuz ağrısı 0-10 cm'lik visüel analog skala (VAS) ile, fonksiyonel durum Western Ontario Rotator Kaf İndeksi (WORC), The Society of the American Shoulder and Elbow Surgeons Evaluation (ASESS) ve Constant skorlaması (CS) ile, yaşam kalitesi short-form 36 (SF-36) ile değerlendirildi. Bu değerlendirmeler tedavi öncesi, tedavi sonrası 3. ve 12. haftalarda yapıldı.Bulgular: Tedavi öncesinde her iki grup arasında yaş, cinsiyet, meslek, eğitim düzeyi, semptom süresi, travma öyküsü, omuz magnetik rezonans görüntüleme (MRG) evresi açısından anlamlı fark yoktu ( p>0.05). Tedavi sonrasında da her iki grupta yapılan egzersiz sayısı ve antienflamatuar ilaç kullanımı açısından da anlamlı bir fark saptanmadı ( p>0.05). Her iki grupta da tedavi ile EHA değerlerinde anlamlı bir iyileşme görüldü (p 0.05).Sonuç: Subakromial sıkışma sendromu tanısı alan hastalarda konvansiyonel egzersize devamlı modda terapotik ultrason eklenmesinin ağrı azalmasına, fonksiyonellik artışına katkı sağladığı bulundu. Objective: The aim of this study is to evaluate the effectiveness of ultrasound therapy on the range of motion, pain, functional tests and quality of life in the patients suffering from the subacromial impingement syndrome .Material-Method: 62 patients with the diagnosis of subacromial impingement syndrome were involved in the study. The patients were classified into two groups randomly. One group (n=31) was given standard exercise program and therapeutic ultrasound and the other group (n=31) was given standart exercise program and sham ultrasound. Then the patients were followed up for 12 weeks. The shoulder range of motion (ROM) of the patients was assessed with goniometer; the shoulder pain at rest, during motion, night pain were evaluated with visual analogue scale (VAS) of 0-10 cm; and the functional status with Western Ontario Rotator Cuff Index (WORC), The Society of the American Shoulder and Elbow Surgeons Evaluation (ASESS) and Constant scoring (CS) These evaluations were done before the treatment and after the treatment on the 3th and 12th weeks.Findings: Before treatment, there was no significant difference between the groups in age, sex, occupation, education level, symptom duration, trauma history, shoulder magnetic resonance imaging phase (p>0.05). After treatment, there was no significant difference between the groups in the number of exercise done and antienflamatuar drug use (p>0.05). Significant recovery was determined in shoulder ROM measurements due to treatment in both groups (p<0.05). There was no significant difference between the groups in ROM values after treatment. VAS scores showed significant improvement in both groups. İmprovement at 12th week was significantly better in ultrasound group than control group in night pain and motion pain scores. ASESS scores were significantly improved in ultrasound group, hovewer improvement in control group was not significant. There was no significant difference between groups in CS before treatment, however CS in ultrasound group at 12th week was significantly better than control group. WORC scores showed significant improved in both groups. Although the difference was not significant, improvement in WORC score in ultrasound group was better than control group. Six of eight SF-36 parameters were significantly improved in ultrasound group, hovewer three of eight SF-36 parameters were significantly improved in control group at 12 weeks. There was no significant difference between groups in SF-36 parameters after treatment.Conclusion: It was found that the therapeutic ultrasound applied together with the conventional exercise program for the subacromial impingement syndrome patients reduces pain and increases the functionality.