Abstract
Purpose:
This study is performed to investigate the effectiveness of upper extremity and scapula Proprioceptive Neuromuscular Facilitation (PNF) techniques in adhesive capsulitis (AC).
Methods:
Thirty-six subjects were randomized into two groups. Control group (n=18) was treated with conventional physiotherapy applications consisting of hot-pack and ultrasound, and wall and wand exercises instructed as a home program; study group (n=18) was treated with upper extremity and scapula PNF patterns besides conventional physiotherapy. Patients were treated five times a week, for a total of 15 sessions. Pain intensity was assessed on a visual analogue scale; postural deformities were evaluated by inspection. Range of shoulder movements (ROM) were measured by a universal goniometer. “Lateral Scapular Slide Test” and assessment of scapular position were used for evaluation of the scapula. Functional performance was assessed by Shoulder Pain and Disability Index (SPADI).
Results:
Intensity of pain during activity significantly decreased and ROM increased in both groups (p<0.05). While increase amounts of shoulder flexion and abduction ROMs were higher in the PNF group (p<0.05), there was no difference between groups in internal and external rotation movements. Although, night pain significantly decreased in the study group (p<0.05), it remained unchanged in the control group (p>0.05). Scapula position didn’t change after therapy in both groups (p>0.05). SPADI scores decreased in both groups (p<0.05).
Discussion:
This study showed that PNF patterns provide significant contribution to night pain and range of flexion and abduction movements in patients with AC. Including PNF applications in AC treatment program may provide better outcomes.
Öz
Amaç:
Bu çalışma adeziv kapsülitli hastalarda, üst ekstremite ve skapula Proprioseptif Nöromusküler Fasilitasyon (PNF) tekniklerinin tedavi etkinliğinin incelenmesi amacıyla gerçekleştirilmiştir.
Yöntemler:
Çalışmaya katılan 36 olgu, rastgele iki gruba ayrılmıştır. Kontrol grubundaki hastalar (n=18) geleneksel fizik tedavi uygulamalarından sıcak yastık, ultrason ve ev programı olarak gösterilen duvar ve baston egzersizleri ile, çalışma grubundaki hastalar (n=18) ise bunların yanı sıra fizyoterapist tarafından uygulanan üst ekstremite ve skapula PNF paternleri ile tedavi edildi. Hastalar haftada 5 kez olmak üzere toplam 15 seans tedavi aldı. Ağrı değerlendirmesi için Vizüel Analog Skalası kullanıldı. Gözlemsel postür analiz yöntemi ile postüral bozukluklar değerlendirildi. Üniversal gonyometre ile eklem hareket açıklığı ölçümü yapıldı. Skapulanın değerlendirmesinde, “Lateral Skapula Kayma Testi” ve skapula pozisyonu değerlendirmesi kullanıldı. “Omuz Ağrı ve Özürlülük İndeksi” ile hastaların fonksiyonel performansı değerlendirildi.
Sonuçlar:
Çalışmanın sonucunda, her iki grupta da aktivite sırasındaki ağrının anlamlı olarak azaldığı ve eklem hareket açıklığının arttığı görüldü (p<0.05). Fleksiyon ve abduksiyon hareket açıklığındaki artış, PNF grubunda fazla olurken (p<0.05), internal ve eksternal rotasyon hareket açıklığında gruplar arasında fark görülmedi. PNF grubunda gece ağrısında azalma tespit edilirken (p<0.05), kontrol grubunda anlamlı bir değişiklik olmadı (p>0.05). Tedavi sonrasında her iki grupta da skapula pozisyonu değişmedi. SPADI skorları ise her iki grupta da anlamlı olarak azaldı (p<0.05).
Tartışma:
Bu çalışma, adeziv kapsülitli hastalarda PNF uygulamalarının gece ağrısı, omuz fleksiyon ve abduksiyon hareket açıklığı parametrelerine anlamlı katkı sağladığını göstermiştir. Adeziv kapsülit tedavi programına PNF uygulamalarının eklenmesi ile daha iyi sonuçlar elde edilebilecektir.
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Eda AKBAŞ, PT, PhD 1 Sinem GÜNERİ, PT, MSc 2 Serkan TAŞ, PT 2 Emin Ulaş ERDEM, PT, PhD, Assoc Prof 1 İnci YÜKSEL PT, PhD, Prof 3
İletişim (Correspondence):
Eda AKBAŞ PT, PhD Department of Physiotherapy and Rehabilitation, School of Health, Bülent Ecevit University, Zonguldak TURKEY. e-mail: akbas.pt@gmail.com
1 Department of Physiotherapy and Rehabilitation, School of Health, Bülent Ecevit University, Zonguldak
2 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hacettepe University, Ankara
3 Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara
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AKBAŞ, E., GÜNERİ, S., TAŞ, S. et al. The effects of additional proprioceptive neuromuscular facilitation over conventional therapy in patients with adhesive capsulitis. Turk J Physiother Rehabil 26, 12 (2015). https://doi.org/10.7603/s40680-015-0012-6
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DOI: https://doi.org/10.7603/s40680-015-0012-6
Keywords:
- Adhesive Capsulitis
- Frozen Shoulder
- Scapula
- Proprioceptive Neuromuscular Facilitation (PNF)
- SPADI (Shoulder Pain and Disability Index)