The Effect of Scapular Proprioceptive Neuromuscular Facilitation Techniques on Pain and Functionality in Patients with Subacromial Impingement Syndrome: A Randomized Controlled Trial

Abstract

Objective To determine the effectiveness of scapular proprioceptive neuromuscular facilitation (PNF) techniques in patients with subacromial impingement syndrome (SIS).

Methods 36 patients were randomized and a 6-week exercise program was applied to both groups 2 days a week. PNF group also received rhythmic initiation and repeated stretch PNF techniques in 2 scapula diagonals. Pain and function were primary outcomes. Active range of motion (ROM), pain pressure threshold (PPT), active myofascial trigger points (MTrPs), scapular dyskinesis, anxiety and depression status were secondary outcomes.

Results The improvement in function, internal rotation ROM, PPT, active MTrPs and patient satisfaction was significantly greater in PNF group than exercise group (p<0.05). Scapular dyskinesis improved only in PNF group (p<0.05). Significant improvement in pain, function, ROM, PPT, active MTrPs, anxiety and depression was found in both groups (p<0.05).

Conclusions Both scapular PNF techniques and standard exercise program are effective in the treatment of SIS. However, scapular PNF techniques can be added to the exercise program to further improve function, ROM, PPT, active MTrPs, scapular dyskinesis, and patient satisfaction.

Zusammenfassung

Fragestellung Ziel der Studie war es, die Wirksamkeit der Techniken der skapulären propriozeptiven neuromuskulären Fazilitation (PNF) bei Patienten mit subakromialem Impingement-Syndrom (SIS) zu prüfen.

Methodik Es erfolgte die Randomisierung von 36 Patienten auf zwei Gruppen, wobei beide Gruppen ein 6-wöchiges Übungsprogramm mit Übungseinheiten an zwei Tagen pro Woche erhielten. In der PNF-Gruppe wurden die Patienten zusätzlich mit der PNF-Technik der rhythmischen Initiation und der wiederholten Dehnung in 2 Skapula-Diagonalen behandelt. Die primären Endpunkte waren Schmerz und Funktion. Aktiver Bewegungsumfang (ROM), Schmerzdruckschwelle (PPT), aktive myofasziale Triggerpunkte (MTrPs), Scapuladyskinesie, Angst und Depressionen waren die sekundären Endpunkte.

Ergebnisse Die Verbesserung der Funktion, des Bewegungsumfangs der Innenrotation, der Schmerzdruckschwelle, der aktiven myofaszialen Triggerpunkte und der Patientenzufriedenheit war in der PNF-Gruppe signifikant größer als in der Gruppe mit alleinigem Übungsprogramm (p<0,05). Nur in der PNF-Gruppe verbesserte sich die Scapuladyskinesie (p<0,05). In beiden Gruppen fand sich eine signifikante Verbesserung von Schmerz, Funktion, ROM, PPT, aktiven MTrPs, Angst und Depression (p<0,05).

Schlussfolgerung Sowohl die skapulären PNF-Techniken als auch das Standardübungsprogramm sind bei der Behandlung von SIS wirksam. Eine Erweiterung des Übungsprogramms um die skapulären PNF-Techniken ist jedoch möglich, um eine zusätzliche Verbesserung von Funktion, ROM, PPT, aktiven MTrPs, Scapuladyskinesie und Patientenzufriedenheit zu erreichen.

Key words

Shoulder pain - proprioceptive neuromuscular facilitation - function - myofascial trigger points

Schlüsselwörter

Schulterschmerzen - myofasziale Triggerpunkte - propriozeptive neuromuskuläre Fazilitation - Funktion

Publication History

Received: 02 November 2021

Accepted: 07 June 2022

Article published online:
14 July 2022

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