EFFECTS OF ELECTRİCAL STİMULATİON WİTH EXERCİSE İN PATİENTS WİTH SUBACROMİAL IMPİNGEMENT SYNDROME

Öz

Aim: In this study, it was aimed to investigate the effects of exercise and neuromuscular electrical stimulation applied to patients with subacromial impingement syndrome on pain, function, rotator cuff muscle strength and supraspinatus muscle architecture. Material and Method: Twenty-four patients with diagnosis of rotator cuff lesions were included in the study. Two groups were formed randomly, as 1st group exercise group (n=12), and 2nd group electrical stimulation (n=12). Shoulder exercises were trained with exercise group once a day, 3 days a week for 6 weeks. In other group, electrical stimulation was performed in addition to exercises. In both groups, pain was evaluated Visual Analog Scale (VAS), Shoulder function was assessed Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), muscle strength was evaluated with isokinetic dynamometer and muscle architecture was evaluated by dynamic tendon method. Results: While there was no statistically significant difference between groups before and after treatment in both groups in terms of VAS, DASH averages and supraspinatus muscle pennation angle and fiber length values evaluated by ultrasonography (p>0.05), there was a statistically significant increase in improvement between the pre- and post-treatment times (p<0.05). Inevaluation of supraspinatus muscle thickness, improvement in the electrical stimulation group was more significant (p<0.05). Improvements were statistically significant in electrical stimulation group (p<0.05). According to muscle strength results evaluated at 60°/sec, it was observed that external and internal rotation forces before and after treatment increased statistically significantly in both groups (p<0.05). Similarly, the increase was statistically higher in electrical stimulation group. Conclusion: In patients with subacromial impingement syndrome with rotator cuff lesion, exercise and electrical stimulation reduce pain, increase muscle strength and muscle architectural parameters, and provide functional recovery after treatment. Well-planned exercise program can also be effective in treatment for patients who can not find treatment in a clinical setting.

Anahtar Kelimeler

• Subacromial impingement syndrome
• muscle architecture
• electrical stimulation
• exercise

SUBAKROMİYAL SIKIŞMA SENDROMLU HASTALARDA EGZERSİZ İLE ELEKTRİK STİMÜLASYONUNUN ETKİLERİ

Öz

Amaç: Bu çalışmada subakromiyal sıkışma sendromlu hastalara uygulanan egzersiz ile nöromusküler elektrik stimülasyonunun ağrı, fonksiyon, rotator kaf kas kuvveti ve supraspinatus kas mimarisi üzerine etkilerini araştırmak amaçlanmıştır. Gereç ve Yöntem: Araştırmaya rotator kaf lezyonları tanısı ile gelen ve ultrasonografik değerlendirme ile subakromiyal sıkışma tespit edilen 24 hasta dahil edildi. Hastalar 1. grup egzersiz (n=12), 2. grup egzersizle birlikte elektrik stimülasyonu uygulanacak grup (n=12) olarak 2 gruba randomize bir şekilde ayrıldı. Egzersiz grubuna 6 hafta boyunca, haftada 3 gün, günde bir kez omuz egzersizleri uygulandı. Diğer gruba ise aynı egzersizlere ilave olarak elektrik stimülasyonu eklendi. Her iki grupta da ağrı, vizuel analog skala (VAS); fonksiyonel durum, Disabilities of the Arm, Shoulder and Hand Questionnare (DASH) ; kas kuvveti, izokinetik dinamometre ve supraspinatus kas mimarisi ise ultrasonagrafi ile değerlendirildi. Bulgular: Her iki grupta da tedavi öncesi ve sonrası gruplar arasında VAS, DASH ortalamaları ve ultrasonografi ile değerlendirilen supraspinatus kası pennasyon açısı ve lif uzunluğu değerleri bakımından istatistiksel olarak anlamlı fark yok iken (p>0,05), tedavi öncesi ve sonrası zamanlar arasında istatistiksel olarak anlamlı ve iyileşme yönünde bir artış saptandı (p<0,05). Supraspinatus kas kalınlığı değerlendirmesinde elektrik stimülasyonu grubundaki düzelme daha belirgindi (p<0,05). İyileşmeler elektrik stimülasyonu grubunda istatistiksel olarak belirgin artış gösterdi (p<0,05). 60°/ sn’de değerlendirilen kas kuvveti sonuçlarına göre tedavi öncesi ve sonrası external ve internal rotasyon kuvvetlerinin her iki grupta da istatistiksel olarak anlamlı derecede arttığı görüldü (p<0,05). Benzer şekilde artış elektrik stimülasyon uygulanan grupta istatistiksel olarak daha fazla idi. Sonuç: Subakromiyal sıkışma sendromu olan hastalarda egzersiz ve egzersize ilave elektrik stimülasyonu uygulamalarının her ikisi de ağrıyı azaltmakta, kas kuvvetini artırmakta, kas mimari parametrelerinde ve fonksiyonel durumda iyileşme sağlamaktadır. Egzersiz tedavisine eklenen elektrik stimülasyon daha fazla iyileşme sağlamaktadır, bununla birlikte klinik ortamda tedavi şansı bulamayan hastalar için iyi planlanmışbir egzersiz programı da tedavide etkili olabilmektedir.

Anahtar Kelimeler

• Subakramiyal sıkışma sendromu
• kas mimarisi
• elektrik stimülasyonu
• egzersiz

Kaynakça

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