Efficacy of Pulse Electromagnetic Field Therapy (PEMF) in Patients With Subacromial Impingement Syndrome
Condition: Shoulder Pain; Musculoskeletal Diseases; Subacromial Impingement Syndrome; Shoulder Injuries and Disorders
MeSH terms: Shoulder Pain; Musculoskeletal Diseases; Shoulder Impingement Syndrome; Syndrome; Rotator Cuff Injuries; Shoulder Injuries
Study type: Interventional

Summary: 
      The aim of our study is to investigate the effectiveness of Pulse Electromagnetic Field
      Therapy (PEMT) versus placebo on pain, quality of life, shoulder function and isokinetic
      assessment, and muscle strength in the treatment of subacromial impingement syndrome.
    

Detailed description: 
      Shoulder pain is one of the common health problems. It ranks third among musculoskeletal
      problems after low back and neck pain. Subacromial Impingement Syndrome (SIS) is the most
      common cause of shoulder pain. SIS is a pathology resulting from mechanical repetitive
      compression and inflammation of the supraspinatus tendon, subacromial-subdeltoid bursa, and
      biceps tendon located under the acromion and coracoacromial ligament. SIS is characterized by
      functional limitation of the shoulder with gradual limitation of both active and passive
      glenohumeral movement due to compression of the subacromial structures. Pain in the anterior
      shoulder region, which is exacerbated by elevation of the shoulder joint or overhead
      activities, and limitation of range of motion are the main reasons for the decrease in
      quality of life in patients with SIS.

      The most common symptom of SIS is pain. The pain is usually at night and radiates to the
      anterior aspect of the shoulder. Night pain often occurs when lying on the affected side and
      is typically in the deltoid region. Symptoms usually increase with abduction, elevation, or
      overhead activities. Patients often complain that they have difficulty reaching their back
      while dressing. Active movements may be restricted due to pain.

      Analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs), steroid injections, physical
      therapy methods, exercise and surgical procedures are used in the treatment of shoulder pain.
      Superficial hot and cold applications, analgesic currents, ultrasound, extracorporeal shock
      wave therapy (ESWT), magnetotherapy, laser and acupuncture are preferred as treatment
      options.

      Magnetotherapy is a treatment method based on magnetic field interaction. As a result of
      pulsed or alternating electromagnetic fields, an electrical current occurs in the tissues.
      Pulse magnetotherapy has three physical mechanisms known to be effective in living tissue:
      Magnetic induction, magneto-mechanical effects, and electronic interactions. Effects of
      magnetic field application are vasodilation, analgesic effect, anti-inflammatory effect,
      acceleration of healing, antiedematous effect. Magnetotherapy increases the oxygen release of
      erythrocytes and provides oxygenation of the tissues. This causes a decrease in toxins in the
      damaged area, an increase in vital nutrients and endorphins. With this physiological change,
      magnetic energy decreases the pain receptor sensitivity that sends a message to the brain.
      With this treatment method, pain reduction is achieved, while joint mobility increases.

      This study was designed as a double-blind, prospective, placebo-controlled, randomized study.
      Participants were randomized into 2 groups: PEMF + therapeutic exercise, sham PEMF +
      therapeutic exercise.

      Shoulder range of motion, Visual Pain Scale (VAS), SF (Short form) -36 Quality of Life Scale,
      Constant Murley Scale, Shoulder pain and disability index, upper extremity muscle strength
      measurement with Isomed 2000 isokinetic device) will be evaluated. It was planned that the
      evaluations were made and recorded by a blinded physician to the groups at the beginning of
      the treatment, at the end of the treatment and at the 3rd month controls.
    

Intervention name(s): Pulse electromagnetic field therapy; Sham pulse electromagnetic field therapy
Intervention type(s): Device; Device
Intervention description(s): It was applied with an electromagnetic field device (ASA Pmt Quatro Pro, ASA Srl Via A.Volta 9-36057 Italia) at 50 Hz frequency, 85 Gauss (8.5 milliTesla) intensity and for 30 minutes. The treatment period was 5 days a week for 4 weeks, in total. It was applied as 20 sessions.
Therapeutic Exercise As a therapeutic exercise program; active shoulder ROM, isometric and progressive strengthening exercises for shoulder girdle muscles, codman pendulum exercises will be performed. It was planned to implement a total of 20 sessions 5 days a week for 4 weeks, for approximately 30 minutes. Exercises will be performed by a trained (at least 5 years experienced) physiotherapist, three times a day, in 3 sets, 10 repetitions.; Sham pulse electromagnetic field therapy was applied five sessions a week for four weeks, for a total of 20 sessions a day, using electromagnetic field device (ASA Pmt Quatro Pro, ASA Srl Via A.Volta 9-36057 Italy) without current flowing through the device.
Therapeutic Exercise As a therapeutic exercise program; active shoulder ROM, isometric and progressive strengthening exercises for shoulder girdle muscles, codman pendulum exercises will be performed. It was planned to implement a total of 20 sessions 5 days a week for 4 weeks, for approximately 30 minutes. Exercises will be performed by a trained (at least 5 years experienced) physiotherapist, three times a day, in 3 sets, 10 repetitions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Pulse Electromagnetic Field Therapy; Subacromial Impingement Syndrome; Shoulder Pain