Subakromial s?k??ma sendrmu olan hastalarda transkutan elektrik sinir stimulasyonu(tens)tedavisinin etkinli?inin ara?t?r?ld??? ?ift k?r plasebo kontroll? randomize ?al??ma

Bu ?al??man?n amac? subakromial s?k??ma sendromu olan hastalarda, transkutan elektrik sinir stim?lasyonu(TENS) tedavisinin a?r?, eklem hareket a??kl???, fonksiyonel testler ve ya?am kalitesi ?zerine etkinli?ini ara?t?rmakt?r. Materyal Metod: Subakromial s?k??ma sendromu tan?s? alan 60 hasta ?al??maya al?nd?. Hastalar randomize edilerek iki gruba ayr?ld?. Bir gruba (n:30) konvansiyonel TENS ve standart egzersiz program?, di?er gruba (n:30) plasebo TENS ve standart egzersiz program? verildi. Hastalar 6 hafta boyunca izlendi. Hastalar?n omuz eklem hareket a??kl??? (EHA) goniometre ile, istirahat, gece ve hareketle olu?an omuz a?r?s? 0-10 cm'lik vis?el analog skala (VAS) ile, fonksiyonel durum Constant skorlamas? (CS), The Society of the American Shoulder and Elbow Surgeons Evaluation(ASESS-100) ve Western Ontario Rotator Kaf ?ndeksi(WORC) ile, ya?am kalitesi short-form 36 (SF-36)'n?n T?rk?e uyarlamas? ile de?erlendirildi. Bu de?erlendirmeler tedavi ?ncesi, tedavi sonras? ve 6. haftada yap?ld?. Bulgular: Tedavi ?ncesinde her iki grup aras?nda ya?, cinsiyet, meslek, e?itim d?zeyi, semptom s?resi, omuz magnetik rezonans g?r?nt?leme (MRG) evresi a??s?ndan anlaml? fark yoktu (p>0.05). Tedavi sonras?nda da her iki grubun ula?t?klar? egzersiz faz?, yap?lan egzersiz say?s?, parasetamol ila? kullan?m? a??s?ndan da anlaml? bir fark saptanmad? (p>0.05). Her iki grupta da tedavi ile EHA de?erlerinde anlaml? iyile?me g?r?l?rken aktif fleksiyon a??s?nda tedavi ?ncesine g?re 6. haftada; aktif abduksiyon a??s?nda tedavi ?ncesine g?re 3. ve 6. haftalarda; pasif abduksiyon a??s?nda ise tedavi ?ncesine g?re 3. haftadaki iyile?menin TENS grubunda anlaml? olarak daha fazla oldu?u saptand?(p<0.05). VAS skorlar?nda her iki grupta anlaml? iyile?me g?r?l?rken VAS istirahat skorunda tedavi ?ncesine g?re 6. haftada ve hareket skorunda tedavi ?ncesine g?re 3. ve 6. haftalardaki iyile?me TENS grubunda anlaml? olarak daha iyi saptand?(p<0.05). Fonksiyonel de?erlendirmede her iki grupta da anlaml? d?zelme g?r?l?rken CS ve ASESS skorlar?nda tedavi ?ncesine g?re 3. ve 6. haftalardaki iyile?me TENS grubunda anlaml? olarak daha iyi saptand? (p<0.05). SF-36 alt b?l?mleri incelendi?inde; her iki grupta fiziksel fonksiyon, fiziksel rol g??l???, a?r?, emosyonel rol g??l???, genel sa?l?k, vitalite ve mental sa?l?k alt b?l?mlerinde anlaml? olarak iyile?me g?r?l?rken TENS grubunda 6 hafta sonunda a?r? alt b?l?m?n?ndeki iyile?menin anlaml? olarak daha fazla oldu?u saptand? (p<0.05). 6 hafta sonunda Mental Fonksiyon ?zet Skor(MCS) ve Fiziksel Fonksiyon ?zet Skor(PCS) de?erlerinde her iki grupta da anlaml? iyile?me saptand? (p<0.05). Sonu?: Subakromial s?k??ma sendromu tan?s? alan hastalarda egzersize TENS tedavisinin eklenmesinin a?r? azalmas?na, eklem hareket a??kl??? ve fonksiyonellik art???na tedavi sonras? ve 6. haftada ek katk? sa?lad??? bulundu. Objective: The aim of this study is to evaluate the effectiveness of Transcutan Electrical Nerves Stimulation treatment ( TENS ) on the range of motion, pain, functional tests and quality of life in the patients suffering from the subacromial impingement syndrome . Material Method: 60 patients with the diagnosis of subacromial impingement syndrome were involved in the study. The patients were classified into two groups randomly. One group (n=30) was given conventional TENS and standard exercise program and the other group (n=30) was given plasebo TENS and standard excercise program. Then patients were followed up for 6 weeks. The shoulder range of motion (ROM) of the patients was assessed with goniometer; the shoulder pain at rest, during motion and night pain were evaluated with visual analogue scale (VAS) of 0-10 cm; the functional status with Constant scoring (CS), The Society of the American Shoulder and Elbow Surgeons Evaluation (ASESS) and Western Ontario Rotator Cuff Index (WORC) and the quality of life with the Turkish form of the short-form 36 (SF-36). These evaluations were done before tratment, after treatment and at the 6th week. Findings: Before treatment, there was no significant difference between the groups in age, sex, occupation, education level, symptom duration, shoulder magnetic resonance imaging phase (p>0.05). There was also no considerable difference between the 2 groups considering excercise phase both group reached, the number of exercises, and the use of paracetamol medicine after the treatment (p>0,05). Significant recovery was determined in shoulder ROM measurements due to treatment in both groups . But improvement on the active flexion at the 6th week and on the active abduction at the 3rd and the 6th weeks comparing to the beginning of the treatment was significantly better in TENS group than control group. Significant recovery was determined on VAS scorings in both groups. Improvement on the VAS rest at the 6th weeks and VAS motion scores at the 3rd and the 6th weeks comparing to the beginning of the treatment was significantly better in TENS group than control group (p<0,05). When sub sections of the SF-36 is evaluated significant recovery was determined in the physical functions, physical difficulties, pain, emotional difficulties, general health situation, vitality and mental health. Improvement on the pain sub section at the end of the 6th week was significantly better in TENS group than control group (p<0,05). In both groups significant recovery was determined in the Summarized Mental Functions Scores (MCS ) and Summarized Physical Functions Score ( PCS ) at the end of the 6th week. Conclusion : It was found that TENS applied together with the conventional exercise program for the subacromial impingement syndrome patients reduces pain, increases the range of motion and functionality after treatment and at the 6th week.

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