DERYA ÇELİK, ATA CAN ATALAR, Sabahattin ŞAHİNKAYA, MEHMET SELAHATTİN DEMİRHAN

Subakromiyal sıkışma sendromunun konservatif tedavisinde kesikli ultrasonun yeri

Amaç: Kesikli ultrasonun subakromiyal sıkışma sendromunun (SSS) tedavisindeki yeri şimdiye kadar yeterince incelenmemiştir. Bu çalışmada ultrasonun SSS’nin konservatif tedavisindeki etkisi araştırıldı. Çalışma planı: Tip II SSS tanısı konan 36 hasta (29 kadın, 7 erkek; ort. yaş 51, dağılım 40-69) randomize olarak iki gruba ayrıldı. Yirmi hastaya (grup 1) kesikli ultrason, 16 hastaya (grup 2) plasebo ultrason uygulandı. İki grupta da tedavi 15 seans (3 hafta) sürdürüldü. Tüm hastalara ultrason dışında aynı standart ﬁzik tedavi ve rehabilitasyon programı uygulandı. Değerlendirmeler, tedaviden önce ve tedaviden üç ve altı hafta sonra yapıldı. Fonksiyonel sonuç Constant skoru, ağrı görsel analog skala ile değerlendirildi; hastaların hareket açıklıkları ölçüldü. Sonuçlar: İki grupta da tedavinin üçüncü ve altıncı haftalarındaki düzelmeler anlamlı bulundu (p0.05). Grup 1 ve 2’de tedavi öncesinde sırasıyla 43.7±12.9 ve 43.9±16.4 olan ortalama Constant skoru altıncı hafta sonunda 65.7±7.7 ve 65.3±7.6’ya yükseldi. Grup 1’de tedaviden önce 5.5 olan ağrı skoru son kontrolde 2’ye, grup 2’de ise 5’ten 1’e düştü. Constant skoru ve ağrı skorundaki düzelmeler iki grup arasında anlamlı farklılık göstermedi (p>0.05). Çıkarımlar: Bulgularımız, SSS tanısı konan hastaların konservatif tedavisinde kesikli ultrason uygulamasının ek yarar sağlamadığını göstermektedir.

Anahtar Kelimeler:

Tedavi sonucu, Plasebo, Omuz sıkışma sendromu, Sonuçların tekrarlanabilirliği, Ultrasonik terapi, Fizik tedavi yöntemleri

The value of intermittent ultrasound treatment in subacromial impingement syndrome

Objectives: The role of intermittent ultrasound in the conservative treatment of subacromial impingement syndrome (SIS) has not been clariﬁed. We aimed to evaluate the efﬁcacy of ultrasound treatment in SIS. Methods: Thirty-six patients (29 females, 7 males; mean age 51 years; range 40 to 69 years) with type II SIS were randomized to two groups to receive intermittent ultrasound (group 1, n=20) and placebo ultrasound (group 2, n=16) for three weeks (15 sessions). All the patients received the same standard physical therapy and rehabilitation modalities besides ultrasound treatment. Evaluations were made before and three and six weeks after treatment. Functional results were assessed by the Constant score, pain was assessed by a visual analog scale, and range of motion was measured. Results: Within-group comparisons showed signiﬁcant improvements in both groups three and six weeks after treatment (p<0.05). Comparison between pretreatment and 6-week values were as follows: the mean ﬂexion increased from 148.8±20.4° to 175.6±6.0° in group 1, and from 165.9±14.1° to 177.4±4.4° in group 2; internal and external rotation increased from 66.8±20.7° and 61.9±22.9° to 83.2±10.9° and 84.4±9.6° in group 1, and from 75.0±17.3° and 70.0±19.8° to 87.1±6.8° and 84.6±8.4° in group 2, respectively. There were no signiﬁcant differences between the two groups with respect to the range of motion at the end of six weeks (p>0.05). The Constant score improved from 43.7±12.9 to 65.7±7.7 in group 1, and from 43.9±16.4 to 65.3±7.6 in group 2. Pain scores decreased from 5.5 to 2 and from 5 to 1 in group 1 and 2, respectively. Improvements in Constant scores and pain scores were similar in both groups (p>0.05). Conclusion: Our ﬁndings suggest that intermittent ultrasound added to conservative treatment of SIS do not provide an additional beneﬁt to the patients.

Keywords:

Treatment Outcome, Placebos, Shoulder Impingement Syndrome, Reproducibility of Results, Ultrasonic Therapy, Physical Therapy Modalities,

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