Treatment of Subacromial Impingement Syndrome: Platelet-Rich Plasma or Exercise Therapy? A Randomized Controlled Trial

Parisa Nejati, Armita Ghahremaninia, Farrokh Naderi, Safoora Gharibzadeh, Ali Mazaherinezhad, Parisa Nejati, Armita Ghahremaninia, Farrokh Naderi, Safoora Gharibzadeh, Ali Mazaherinezhad

Abstract

Background: Subacromial impingement syndrome (SAIS) is the most common disorder of the shoulder. The evidence for the effectiveness of treatment options is inconclusive and limited. Therefore, there is a need for more evidence in this regard, particularly for long-term outcomes.

Hypothesis: Platelet-rich plasma (PRP) would be an effective method in treating subacromial impingement.

Study design: Randomized controlled trial; Level of evidence, 1.

Methods: This was a single-blinded randomized clinical trial with 1-, 3-, and 6-month follow-up. Sixty-two patients were randomly placed into 2 groups, receiving either PRP or exercise therapy. The outcome parameters were pain, shoulder range of motion (ROM), muscle force, functionality, and magnetic resonance imaging findings.

Results: Both treatment options significantly reduced pain and increased shoulder ROM compared with baseline measurements. Both treatments also significantly improved functionality. However, the treatment choices were not significantly effective in improving muscle force. Trend analysis revealed that in the first and third months, exercise therapy was superior to PRP in pain, shoulder flexion and abduction, and functionality. However, in the sixth month, only shoulder abduction and total Western Ontario Rotator Cuff score were significantly different between the 2 groups.

Conclusion: Both PRP injection and exercise therapy were effective in reducing pain and disability in patients with SAIS, with exercise therapy proving more effective.

Keywords: PRP; exercise therapy; subacromial impingement syndrome.

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This study was funded and supported by the Iran University of Medical Sciences grant 92-01-30-21391.

Figures

Figure 1.
Figure 1.
The CONSORT (Consolidated Standards of Reporting Trials) flowchart of the study.
Figure 2.
Figure 2.
Comparison of flexion range of motion (ROM) between the 2 groups. PRP, platelet-rich plasma.
Figure 3.
Figure 3.
Comparison of total Western Ontario Rotator Cuff Index (WORC) between the 2 groups. PRP, platelet-rich plasma.
Figure 4.
Figure 4.
Comparison of pain visual analog scale (VAS) between the 2 groups. PRP, platelet-rich plasma.
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