The effectiveness of routine physiotherapy with and without neuromobilization on pain and functional disability in patients with shoulder impingement syndrome; a randomized control clinical trial

Abstract

Background The objective of the study was to compare the effects of neuromobilization (NM) techniques and routine physiotherapy on pain and functional disability in patients having shoulder impingement syndrome (SIS). Present study was aimed to discover evidence based conservative and cost effective remedy on pain and functional disability. Study design Single blinded randomized control clinical trial. Methods A total of 80 patients with SIS were randomly assigned into care and experimental groups (40 in each group). After the baseline assessment routine physiotherapy was executed on both groups, while NM was applied additionally to experimental group. Pain and functional disability score were evaluated by Visual Analogue Scale and University of California at Los Angeles rating score at baseline, 5th and 11th week. Differences in outcome between groups were evaluated with clinical improvement. Results The experimental group compared with care group at 11th week had lower mean pain score 2.15(1.66–2.64) vs 4.90(4.41–5.40); between group difference, 1.82; 95% (CI), − 2.38 to − 1.25; P < 0.001 and Partial ƞ2 = 0.33, similarly functional disability score 28.58(27.32–29.83) vs 20.10(18.84–21.36); between group difference,5.62; 95%CI, (4.32–6.92); P< 0.001 and Partial ƞ2 = 0.49 respectively. In experimental group NM was a more effective technique to reduce the pain severity and disability in SIS patients as compare to care group. Conclusion Neuromobilization techniques in addition to routine physiotherapy were significantly effective for the treatment of SIS. Trial registration IRCT20190121042445N1, Registered 19 February 2019.

Effectiveness of Neural Mobilisation on Pain Intensity, Functional Status, and Physical Performance in Adults with Musculoskeletal Pain – A Systematic Review with Meta-Analysis

“…Of these, 27 reports were excluded and 40 remained for this systematic review, considering that 14 studies were included from other sources. Taking into account that two reports were related to the same study, 49 , 50 a total of 39 studies were included 49 – 88 ( Figure 1 ). The excluded reports are listed in Supplemental File 4 with the reasons for exclusion.…”

“…One randomised controlled trial 72 on ankle sprain, with some concerns about the risk of bias for all outcomes, compared a 4-week intervention of neural mobilisation (tensioning and passive techniques) as part of a multimodal intervention against proprioceptive/strengthening exercises for pain intensity, functional ankle instability, pressure pain threshold, muscle strength, and active range of motion in participants with recurrent ankle One randomised controlled trial 85 on shoulder impingement syndrome, at high risk of bias for outcomes measured, compared a 5-week intervention of neural mobilisation (sliding and tensioning techniques combined and active and passive techniques combined) as part of a multimodal intervention against electrotherapy and exercises for pain intensity and functional status (n = 80). There were large and significant differences favouring the neural mobilisation group for pain intensity (effect size = −1.89, 95% confidence interval: −2.41; −1.36) and functional status (effect size = 2.48, 95% confidence interval: 1.90; 3.07).…”

Effects of Functional Electrical Stimulation with and without Kinesiotherapy on Pain, Range of Motion and Quality of Life in Patients with Cervical Dystonia; A Randomized Clinical Trial

“…The session started with four repetitions of each exercise and then the number of repetitions was gradually increased until the patient could perform fifteen repetitions deprived of the stimulus of the dystonic movements. 30 Each time the patient maintained his or her performance for three sessions, the number of repetitions was increased and five or more repetitions were added to the series. The physical therapist recommended resisted cervical and trunk rotations of about twenty degrees to both sides and performed rhythmical stabilization of the scapula and upper extremities (proprioceptive neuromuscular facilitation).…”

Subacromial content to subacromial space ratio in neutral position of the arm as diagnostic criteria of subacromial impingement syndrome

“…Shoulder impingement is the painful entrapment of the soft tissues in the shoulder outlet. [ 4 ] The estimated prevalence of shoulder complaints is 7%–34% with about 1.47% incidence. SIS is believed to be the most common cause of shoulder pain, accounting for 44%–65% of all shoulder complaints.…”