Transcutaneous Pulse Radiofrequency Treatment for Subacromial Impingement Syndrome
Condition: Shoulder Impingement Syndrome
MeSH terms: Shoulder Impingement Syndrome; Syndrome; Rotator Cuff Injuries
Study type: Interventional

Summary: 
      Shoulder pain is the most common musculoskeletal problem after low back and neck pain.
      Subacromial impingement syndrome is one of the most common diseases that causes shoulder
      pain. Many methods are used to reduce pain and accelerate functional rehabilitation in
      patients with shoulder pain. Transcutaneous pulse radiofrequency therapy (TCPRF) is a
      needle-free, painless, and outpatient physical therapy modality that can be used to treat
      shoulder impingement syndrome. Acromio-humeral distance and supraspinatus tendon thickness
      measurements with ultrasound are reliable and effective methods to diagnose subacromial
      impingement syndrome. Although there are previous studies investigating the effectiveness of
      TCPRF treatment in patients with shoulder pain, there are no studies evaluating the
      effectiveness of treatment with ultrasound examination. In this study, the investigators
      aimed to show the effect of TCPRF treatment on pain, range of motion, functional status and
      ultrasound findings in subacromial impingement syndrome.
    

Detailed description: 
      Shoulder pain is the most common musculoskeletal problem after low back and neck pain. It has
      negative socioeconomic effects on patient's daily life (1). Subacromial impingement syndrome
      is one of the most common diseases of the shoulder and seen in 44-65% of patients who consult
      a doctor with shoulder pain. This syndrome spectrum includes supraspinatus tendon partial
      tears, supraspinatus tendinitis, calcific tendinitis and subacromial bursitis. Many
      treatments are used to reduce pain and accelerate functional rehabilitation in patients with
      shoulder pain. These treatments include analgesic physical therapy agents (superficial hot
      and cold applications, deep heaters, diadynamic currents, transcutaneous electrical
      stimulation, interferential current, short wave diathermy), therapeutic exercises, massage,
      functional electrical stimulation, acupuncture, analgesics, non-steroid anti-inflammatory
      drugs, oral steroids and steroid injections. Transcutaneous pulse radiofrequency therapy
      (TCPRF) is a painless and outpatient physiotherapy modality that does not require any
      anesthesia or sedation. TCRPF can also be used in some other painful conditions of the chin,
      neck, lower back, wrist, knee, elbow and ankle regions. Ultrasound measurement of
      acromio-humeral distance and supraspinatus tendon thickness are reliable and effective
      methods for demonstrating subacromial impingement syndrome. Although there have been previous
      studies investigating the effectiveness of TCPRF treatment in patients with shoulder pain,
      the number of these studies are insufficient. In addition, there are no studies evaluating
      the effectiveness of treatment by ultrasound examination. In this study, the investigators
      aimed to evaluate the effect of TCPRF treatment on pain, range of motion and functional
      status in subacromial impingement syndrome patients by means of clinical and ultrasound
      findings.

      The study will be conducted between January 2020 and January 2021 at Gazi University Faculty
      of Medicine, Department of Physical Medicine and Rehabilitation. Fifty patients with
      subacromial impingement syndrome are planned to be recruited for the study.

      The patients included in the study will be randomized into two groups with a computer
      program. In order to comply with the double-blind study protocol, the researcher performing
      the randomization of the patients will not participate in the treatment and evaluation
      processes. Demographic data of patients will be recorded at the beginning of the study.
      Therapeutic exercises and nonsteroidal anti-inflammatory drug therapy will be initiated to
      all patients. Detailed shoulder joint range of motion examination, visual analog scale,
      shoulder pain and disability index, quality of life scale (SF-36), shoulder ultrasound
      examination for acromio-humeral distance and supraspinatus tendon thickness measurements will
      be performed before and after treatment (Basal, 1st, 4th and 12th weeks). A pair of TCPRF
      electrodes will be applied to the painful shoulder at six standardized sites for 2 minutes
      each (approximately a total of 15 minutes). The device is not going to be activated in the
      control group. It will be activated in the study group. In the study group device will be set
      at 80 V, every pulse will continue for 10 milliseconds and 5 pulses per second. In the
      control group the device will be set at 0 V. TCPRF treatment is going to be applied for one
      session in both groups. During the three-month follow-up period, therapeutic exercises and as
      long as it is considered necessary nonsteroidal anti-inflammatory drugs will be continued in
      both groups.
    

Intervention name(s): Transcutaneous pulse radiofrequency therapy
Intervention type(s): Device
Intervention description(s): Transcutaneous pulse radiofrequency therapy (TCPRF) is a painless and outpatient physiotherapy modality
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Shoulder Pain; Transcutaneous radiofrequency treatment; Ultrasound