PNF in Subacromial Impingement Syndrome

This randomized controlled trial was conducted in the Outpatient Clinic of a Physiotherapy and Rehabilitation Department in Ankara, Turkey. The demographic and clinical characteristics of the patients were recorded. Voluntary patients with SIS were regarded as eligible for the study if they met the inclusion criteria. Pain, posture and functionality were assessed before and after intervention. Patients who met the inclusion criteria and agreed to participate were randomly allocated to Group 1 [Conventional therapy (CT)], Group 2 [CT+ PNF in extremity pattern] and Group 3 [CT+ PNF in extremity pattern+PNF in scapula and upper trunk patterns]. A simple randomization method was used with opaque sealed envelopes containing "A", "B" or "C". Group allocation was performed by an independent therapist, not involved in the study. All patients received physiotherapy for approximately 60 mins each session, 3 sessions per week for 6 weeks. Conventional therapy consisted of cold pack (15 minutes); pulsed ultrasound therapy (1 watt/cm², 3 MHz, 1:2 pulsed mode; 3 minutes); transcutaneous electrical nerve stimulation (60-120 Hz; 20 minutes) and exercises (20 minutes). The exercises included stretching, strengthening and posture exercises. The exercises, and the duration and intensity of conventional physiotherapy were selected according to previous studies which showed that a physiotherapy program 3 times a week for 6 weeks was effective in improving function and relieving pain in SIS. The physiotherapy program was applied to all patients at the same intensity by the same physiotherapist and patients did the exercises every day throughout the 6-week period. The patients were also advised to avoid overhead activities.

Inclusion criteria

• patients diagnosed with SIS,
• aged between 18 and 65 years,
• shoulder pain ongoing for more than four weeks,
• loss of active shoulder motion or painful ROM,
• no treatment related to the shoulder in the last 6 months.

Exclusion criteria

• history of frozen shoulder,
• disorders of the acromioclavicular joint,
• possession of a curved or hooked acromion,
• shoulder instability,
• degenerative arthritis of the glenohumeral joint,
• calcifying tendonitis,
• post-traumatic disorders,
• shoulder surgery and/or elbow, hand, wrist and cervical spine disorders,
• diseases that can cause positional vertigo.