The Physiotherapy Approaches in Patients With Subacromial Impingement Syndrome

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

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.

Study Overview

• Status: Completed
• Conditions: Subacromial Impingement Syndrome
• Intervention / Treatment: Procedure: Proprioception exercises; Procedure: Wand Exercise; Procedure: Proprioception exercises with Electromyographic Biofeedback

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Actual): 48
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Florya
    • Istanbul, Florya, Turkey
      • Istanbul Aydin University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Proprioception Exercise Group; Wand exercises and Proprioception exercises	Procedure: Proprioception exercises; Patients trained for proprioception exercises.; Procedure: Wand Exercise; Patients were educated with wand exercises.
Active Comparator: Proprioception exercises with Electromyographic Biofeedback; Wand exercises and Proprioception exercises with Electromyographic Biofeedback	Procedure: Wand Exercise; Patients were educated with wand exercises.; Procedure: Proprioception exercises with Electromyographic Biofeedback; Patients trained for Proprioception exercises with Electromyographic Biofeedback

What is the study measuring?

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
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
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
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

Collaborators and Investigators

• Sponsor: Istanbul University - Cerrahpasa (IUC)
• Investigators: Principal Investigator: Ebru Kaya Mutlu, Professor, Bandırma Onyedi Eylül University; Study Chair: Buse Aydin, M.Sc., Istabul Aydin University; Study Chair: Yasemin Karaaslan, Asst. Prof., Mustafa Kemal University; Study Chair: Hanifegül Taskiran, Professor, Istanbul Aydın University; Study Chair: Nezih Ziroglu, MD, Acıbadem Mehmet Ali Aydınlar University

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2021
• Primary Completion (Actual): August 1, 2021
• Study Completion (Actual): December 1, 2021

Study Registration Dates

• First Submitted: November 27, 2023
• First Submitted That Met QC Criteria: November 27, 2023
• First Posted (Actual): December 5, 2023

Study Record Updates

• Last Update Posted (Estimated): December 11, 2023
• Last Update Submitted That Met QC Criteria: December 5, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: biofeedback; proprioception; shoulder pain; Shoulder impingement syndrome
• Additional Relevant MeSH Terms: Pathologic Processes; Wounds and Injuries; Disease; Joint Diseases; Musculoskeletal Diseases; Rupture; Shoulder Injuries; Tendon Injuries; Syndrome; Rotator Cuff Injuries; Shoulder Impingement Syndrome
• Other Study ID Numbers: ISTANBUL AYDIN UNIVERSITY

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No