Comparing of the efficacy and effectiveness of isokinetic exercise, laser, pseudoiontophoresis and iontophoresis treatments according to the stage in treatments of subacromial impingement syndrome

Abstract

Objective: The aim of this study is to investigate effectiveness of isokinetic exercise, laser, pseudoiontophoresis and iontophoresis treatment in subacromial impingement syndrome (SIS) patients, and compare this effectiveness according to the stages. Material and Methods: 242 patients who were diagnosed subacromial impingement syndrome were included to study. Patients divided 4 groups. There were three stages in each group (stage 2, stage 3 partial tear, stage 3 complete rupture). Isokinetic exercise to first group's all stages, diclofenac gel by iontophoresis method to second group, laser treatment to third group, and diclofenac gel to fourth group were applied, and iontophoresis device was not worked. All of the treatment was performed three times a week and was carried out for 6 weeks (18 session). Pre-treatment and post-treatment pain of patients was evaluated by Visual Analogue Scale, shoulder function was evaluated by Constant Score and Shoulder Disability Score, and quality of life was assessed using the Nottingham Health Profile. Results: At the end of our study; in all groups in all scores were improved after treatment compared to pre-treatment. The comparison between the groups we have found that the most effective method in all scores is isokinetic exercise, and the least effective method is pseudoiontophoresis method. Laser and iontophoresis treatments provided greater recovery compared to pseudoiontophoresis. Compared to iontophoresis with laser, laser provided greater recovery although is not statistically important. Compared to patients by stage, revealed recovery after treatment than before treatment in all groups. Isokinetic treatment is the most effective, laser treatment is normal effective and pseudoiontophoresis treatment is the least effective were found in all stages. Conclusion: As a result, treatments in four groups and in three stages were effect of after the treatment. If we compare the methods with each other, laser and iontophoresis methods are more superior and more effective than pseudoiontophoresis method, but not as isokinetic method.