Egzersiz tedavisine ek olarak Kinezyo bant uygulaması subakromiyal sıkışma sendromu bulgularında iyileşme sağlar mı? Randomize, çift-kör, kontrollü klinik çalışma

Öz

Amaç: Bu çalışmanın amacı subakromiyal sıkışma sendromunda (SSS) egzersiz tedavisine ek olarak uygulanan Kinezyo bant (KB) uygulanmasının etkinliğini belirlemekti. Çalışma planı: Subakromiyal sıkışma sendromlu hastalar (25 kadın, 13 erkek) terapötik KB (n=19) ve etkin sonuç vermeyen KB (n=19) olarak rastgele iki gruba ayrıldı. Tüm hastalar, 12 gün süreyle aynı egzersiz tedavisini ve ek olarak 3 günlük uygulamalarla terapötik ya da etkin sonuç vermeyen KB tedavisini aldılar. Tedaviden önce ve tedavinin 5 ve 12. günlerinde hastalar ağrı, eklem hareket açıklığı (EHA), kas kuvvetleri, DASH ve Constant skorlaması yönünden karşılaştırıldılar. Bulgular: Grup içi karşılaştırmalarda, her iki grupta da 5. ve 12. gün değerlendirmelerinde anlamlı iyileşmelerin olduğu görüldü (p<0.05). Gruplar arası karşılaştırmalarda, hareket ile ağrı ve DASH skorları tedavi grubunda beşinci günde anlamlı olarak düşüktü (p<0.01). Tedavi grubunda 12. günde; gece ağrısı, hareket ile ağrı, DASH skoru, omuz eksternal rotasyon kas gücü ve ağrısız omuz abdüksiyon EHA’sında önemli iyileşmeler kaydedildi (p<0.05). Pasif omuz fleksiyon EHA derecesinin 12. günde etkin sonuç vermeyen bantlama grubunda daha fazla arttığı bulundu (p<0.05). Çıkarımlar: Bulgularımız, egzersiz tedavisine ek olarak uygulanan KB’nin, SSS’nin tedavisinde sadece egzersiz uygulanan tedaviden daha etkili olduğunu göstermektedir.

Anahtar Kelimeler

• Ağrı; egzersiz tedavisi; fonksiyon; Kinezyo bant; subakromiyal sıkışma sendromu.

Does Kinesio taping in addition to exercise therapy improve the outcomes in subacromial impingement syndrome? A randomized, double-blind,controlled clinical trial

Öz

Objective: The aim of this study was to determine the effectiveness of Kinesio taping (KT) application added to the exercise treatment of subacromial impingement syndrome (SIS).
Methods: Thirty-eight (25 female, 13 male) patients with SIS were randomly divided into therapeutic KT (n=19) and sham KT (n=19) groups. All patients received the same exercise therapy in addition to therapeutic or sham KT at 3-day intervals for 12 days. The groups were compared according to pain, range of motion (ROM), muscle strength and DASH and Constant scores before treatment and at the 5th and 12th treatment days.
Results: Within group comparisons showed significant improvements in both groups at the 5th and 12th day evaluations (p<0.05). In comparisons between the groups, pain with movement and DASH scores in the therapeutic group were significantly lower at the 5th day (p<0.01). There were significant improvements in night pain, pain with movement, DASH score, shoulder external rotation muscle strength, and pain free shoulder abduction ROM in the therapeutic group at the 12th day (p<0.05). Passive shoulder flexion ROM increased more in the sham group at the 12th day (p<0.05).
Conclusion: The addition of KT application to the exercise program appears to be more effective than the exercise program alone for the treatment of SIS.

Anahtar Kelimeler

• Exercise therapy
• function
• Kinesio tape
• pain
• subacromial impingement syndrome

Kaynakça

1. Green S, Buchbinder R, Hetrick S. Physiotherapy interventions for shoulder pain. Cochrane Database Syst Rev 2003;2: CD004258.
2. Van der Windt DA, Koes BW, Boeke AJ, Devillé W, De Jong BA, Bouter LM. Shoulder disorders in general practice: prognostic indicators of outcome. Br J Gen Pract 1996;46: 519Michener LA, Walsworth MK, Burnet EN. Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review. J Hand Ther 2004;17:152-64.
3. Neer CS. 2nd. Impingement lesions. Clin Orthop Relat Res 1983;(173):70-7.
4. Kamkar A, Irrgang JJ, Whitney SL. Nonoperative management of secondary shoulder impingement syndrome. J Orthop Sports Phys Ther 1993;17:212-24.
5. Baltac› G. Subacromial impingement syndrome in athletes: prevention and exercise programs. [Article in Turkish] Acta Orthop Traumatol Turc 2003;37 Supp l:128-38.
6. Morrison DS, Greenbaum BS, Einhorn A. Shoulder impingement. Orthop Clin North Am 2000;31:285-93.
7. Celik D, Akyüz G, Yeldan I. Comparison of the effects of two different exercise programs on pain in subacromial impingement syndrome. Acta Orthop Traumatol Turc 2009;43:504-9. Rhon DI, Boyles RE, Cleland JA, Brown DL. Manual physical therapy approach versus subacromial corticosteroid injection for treatment of shoulder impingement syndrome: a protocol for a randomised clinical trial. BMJ Open 2011; 1:e000137.
8. Senbursa G, Baltaci G, Atay A. Comparison of conservative treatment with and without manual physical therapy for patients with shoulder impingement syndrome: a prospective, randomized clinical trial. Knee Surg Sports Traumatol Arthrosc 2007;15:915-21.

9. Green S, Buchbinder R, Glazier R, Forbes A. Systematic review of randomised controlled trials of interventions for painful shoulder: selection criteria, outcome assessment, and efficacy. BMJ 1998;316:354-60.
10. Celik D, Atalar AC, Güçlü A, Demirhan M. The contribution of subacromial injection to the conservative treatment of impingement syndrome. Acta Orthop Traumatol Turc 2009;43:331-5.
11. Celik D, Atalar AC, Sahinkaya S, Demirhan M. The value of intermittent ultrasound treatment in subacromial impingement syndrome. Acta Orthop Traumatol Turc 2009;43:243-7. Hsu CJ, Wang DY, Tseng KF, Fong YC, Hsu HC, Jim YF. Extracorporeal shock wave therapy for calcifying tendinitis of the shoulder. J Shoulder Elbow Surg 2008;17:55-9.
12. Kalter J, Apeldoorn AT, Ostelo RW, Henschke N, Knol DL, van Tulder MW. Taping patients with clinical signs of subacromial impingement syndrome: the design of a randomized controlled trial. BMC Musculoskelet Disord 2011; 12:1
13. Miller P, Osmotherly P. Does scapula taping facilitate recovery for shoulder impingement symptoms? A pilot randomized controlled trial. J Man Manip Ther 2009;17:E6-E13. Kaya E, Zinnuroglu M, Tugcu I. Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome. Clin Rheumatol 2011;30:201-7.
14. Kase K, Wallis J, Kase T. Clinical therapeutic applications of the kinesio taping method. Tokyo: Ken Ikai Co Ltd.; 2003. Akbafl E, Atay AO, Yüksel I. The effects of additional kinesio taping over exercise in the treatment of patellofemoral pain syndrome. Acta Orthop Traumatol Turc 2011;45:335
15. Frazier S, Whitman J, Smith M. Utilization of kinesio tex tape in patients with shoulder pain or dysfunction: a case series. Advanced Healing 2006;Summer:18-20.
16. Thelen MD, Dauber JA, Stoneman PD. The clinical efficacy of kinesio tape for shoulder pain: a randomized, doubleblinded, clinical trial. J Orthop Sports Phys Ther 2008;38: 389Hsu YH, Chen WY, Lin HC, Wang WT, Shih YF. The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome. J Electromyogr Kinesiol 2009;19:1092-9.
17. Düger T, Yakut E, Öksüz Ç, Yörükan S, Bilgütay BS, Ayhan Ç, et al. Reliability and validity of the Turkish version of the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. [Article in Turkish] Fizyoterapi ve Rehabilitasyon 2006; 17:99-107.
18. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987; (214):160-4.
19. Andrews AW, Thomas MW, Bohannon RW. Normative values for isometric muscle force measurements obtained with hand-held dynamometers. Phys Ther 1996;76:248-59.
20. Cakmak A. Conservative treatment of subacromial impingement syndrome. [Article in Turkish] Acta Orthop Traumatol Turc 2003;37 Suppl 1:112-8.
21. Page P, Ellenbecker TS. The scientific and clinical application of elastic resistance. Champaign, IL: Human Kinetics; 2003.
22. Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg 2009;18:138
23. Bİhmer AS, Staff PH, Brox JI. Supervised exercises in relation to rotator cuff disease (impingement syndrome stages II and III): a treatment regimen and its rationale. Physiother Theory Pract 1998;14:93-105.
24. Williams S, Whatman C, Hume PA, Sheerin K. Kinesio taping in treatment and prevention of sports injuries: a metaanalysis of the evidence for its effectiveness. Sports Med 2012; 42:153-64.
25. Yoshida A, Kahanov L. The effect of kinesio taping on lower trunk range of motions. Res Sports Med 2007;15:103-12.
26. González-Iglesias J, Fernández-de-Las-Peñas C, Cleland JA, Huijbregts P, Del Rosario Gutiérrez-Vega M. Short-term effects of cervical kinesio taping on pain and cervical range of motion in patients with acute whiplash injury: a randomized clinical trial. J Orthop Sports Phys Ther 2009;39:515-21.
27. Farina D, Arendt-Nielsen L, Merletti R, Graven-Nielsen T. Effect of experimental muscle pain on motor unit firing rate and conduction velocity. J Neurophysiol 2004;91:1250-9.
28. Bandholm T, Rasmussen L, Aagaard P, Diederichsen L, Jensen BR. Effects of experimental muscle pain on shoulderabduction force steadiness and muscle activity in healthy subjects. Eur J Appl Physiol 2008;102:643-50.
29. Lin JJ, Hung CJ, Yang PL. The effects of scapular taping on electromyographic muscle activity and proprioception feedback in healthy shoulders. J Orthop Res 2011;29:53-7.
30. Słupik A, Dwornik M, Bia∏oszewski D, Zych E. Effect of Kinesio Taping on bioelectrical activity of vastus medialis muscle. Preliminary report. Ortop Traumatol Rehabil 2007; 9:644-51.
31. Huang CY, Hsieh TH, Lu SC, Su FC. Effect of the Kinesio tape to muscle activity and vertical jump performance in healthy inactive people. Biomed Eng Online 2011;10:70.
32. Fu TC, Wong AM, Pei YC, Wu KP, Chou SW, Lin YC. Effect of Kinesio taping on muscle strength in athletes - a pilot study. J Sci Med Sport 2008;11:198-201.
33. Herrington L. The effect of patella taping on quadriceps strength and functional performance in normal subjects. Phys Ther Sport 2004;5:33-36.
34. Surenkok O, Aytar A, Baltaci G. Acute effects of scapular mobilization in shoulder dysfunction: a double-blind randomized placebo-controlled trial. J Sport Rehabil 2009;18: 493-50