The Physiotherapy Approaches in Patients With Subacromial Impingement Syndrome

Study Overview
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Brief Summary
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The aim of this study is to investigate the effectiveness of Electromyographic Biofeedback with proprioception exercises on pain, range of motion, muscle strength, proprioception and functionality in patients with subacromial impingement syndrome.

Detailed Description
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This study is planned as a prospective, randomized clinical study. Patients with subacromial impingement syndrome who volunteered to participate in the study, met the inclusion criteria, and signed the consent form were randomly assigned to the proprioception exercise group and the proprioception exercise with electromyographic biofeedback group. Demographic and clinical data of the patients were recorded. Shoulder function with Disabilities of the Arm, Shoulder and Hand scale, pain with VAS, painless active shoulder flexion, abduction, and external-internal rotation with goniometer, muscle strength with Manual Muscle Tester, proprioception (55°-90°- 125° angles of flexion and abduction, and angular deviations) with the Laser-pointer assisted angle reproduction test were evaluated, and patient satisfaction was evaluated with The Global Rating of Change Scale. After the initial evaluations were completed, only proprioception exercises and proprioception exercises with EMG-BF were applied 2 days a week for 8 weeks. Additionally, both groups were given Want exercises.

Official Title
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The Effect of Electromyographic Biofeedback and Proprioception Exercises on Pain and Functionality in Patients With Subacromial Impingement Syndrome: A Randomized Controlled Study

Conditions
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Subacromial Impingement Syndrome

Intervention / Treatment
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* Procedure: Proprioception exercises
* Procedure: Proprioception exercises with Electromyographic Biofeedback
* Procedure: Wand Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being diagnosed with subacromial impingement syndrome, Being between the ages of 18 and 65, Not having received medical treatment, Not having received a shoulder-related physiotherapy program in the last year, Not having had any shoulder-related surgery, Exclusion Criteria: Neurological deficits of the upper extremity and the presence of another orthopedic disorder, rheumatic or congenital disease other than subacromial impingement syndrome, Presence of mental problem, Having received corticosteroid treatment in the last year, Upper extremity fracture, Acute cervical pathology, Having cardiovascular and systemic diseases that prevent working, Pregnancy, Those with communication problems.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The study consisted of patients with subacromial impingement syndrome evaluated by an orthopedist. Patients who met the inclusion criteria were divided into two groups.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Proprioception Exercise Group<br>Wand exercises and Proprioception exercises | Procedure: Proprioception exercises<br>* Patients trained for proprioception exercises.<br>Procedure: Wand Exercise<br>* Patients were educated with wand exercises.<br>|
| Active Comparator: Proprioception exercises with Electromyographic Biofeedback<br>Wand exercises and Proprioception exercises with Electromyographic Biofeedback | Procedure: Proprioception exercises with Electromyographic Biofeedback<br>* Patients trained for Proprioception exercises with Electromyographic Biofeedback<br>Procedure: Wand Exercise<br>* Patients were educated with wand exercises.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disabilities of the Arm, Shoulder and Hand scale | The Disabilities of the Arm, Shoulder and Hand scale was used to measure shoulder function. The Disabilities of the Arm, Shoulder and Hand scale consists of 30 items. The total score that can be obtained from items scored between 1-5 varies between 0-100. An increase in the score indicates a decrease in function. | 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analogue scale | The severity of pain was measured Visual analogue scale. ccording to this scale, patients rated their pain between 0 and 10. As the score increases, the pain increases. | 8 weeks | 
| Joint range of motion | Active shoulder flexion, abduction, and external-internal rotation range of motion was measured with goniometer. | 8 weeks | 
| Muscle strength | Shoulder flexion, abduction, and external-internal rotator muscle strength was measured with manual muscle tester. | 8 weeks | 
| Proprioception | To evaluate joint position sense, laser pointer-assisted angle reproduction test was applied for measurements at 55°-90°-125° flexion and abduction angles. | 8 weeks | 
| Patient satisfaction | The amount of improvement or deterioration in patients was assessed with the Global Rating Change Scale.This scale is scored according to a 7-point Likert type (-3: much worse, -2: worse, -1: slightly worse, 0: the same, 1: slightly better, 2: quite better, 3: much better). | 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Shoulder impingement syndrome, shoulder pain, proprioception, biofeedback