Last update:
15-Jan-2020

OBJECTIVE To determine the effectiveness of corrective therapeutic exercise alone, compared with its combination with manual therapy or electrotherapy in the improvement of clinical parameters in patients with painful shoulder.

METHOD A pilot randomized controlled trial was conducted on 25 patients suffering from shoulder pain, disability and restriction of the range of motion in the shoulder joint. The patients, who participated voluntarily, with no form of blinding, were divided randomly into three groups. The first group followed a corrective therapeutic exercise program using elastic bands and a specialized suspension system for the upper extremity (control group). In the second and third groups, in addition to the corrective exercise program, manual therapy of the glenohumeral joint or Tecar electrotherapy were applied, respectively. Pain and disability were assessed using the Oxford Shoulder Score and the Shoulder Pain and Disability Index, and the active and passive range of motion of shoulder joint movements (flexion, abduction, internal and external rotation) was measured. A total of 12 therapeutic sessions were administered, and assessment was performed at the 1st, 8th and 12th sessions. The frequency of the sessions was 2 sessions/week for the first 4 weeks and 1 session/week for the remaining 4 weeks. Statistical analysis was conducted using the two-way repeated measures analysis of variance (ANOVA) with the Statistical Program for Social Sciences (SPSS), v. 20.0.

RESULTS All three groups exhibited significant improvement in pain and disability, as assessed by the scores of the participants on both questionnaire, between the 1st and the 8th and between the 1st and the 12th sessions (p<0.05– 0.01). Regarding the range of motion of the shoulder, significant improvement (p<0.05–0.01) was revealed between the 1st and the 8th sessions (apart from active internal rotation), and between the 1st and the 12th sessions in all movements apart from active and passive flexion. No significant differences were observed between the 8th and 12th sessions, in any of the parameters assessed (p>0.05).

CONCLUSIONS The findings of this pilot study suggest that corrective therapeutic exercise is an effective intervention for rehabilitation in disability and reduced range of motion, and for pain reduction in patients with painful shoulder. The addition of manual therapy or Tecar electrotherapy did not result in additional improvement in these clinical parameters. A larger number of patients is required for further documentation of the effectiveness of conservative therapeutic interventions in patients with painful shoulder.

Key words: Electrotherapy, Exercise therapy, Manual therapy, Physiotherapy, Shoulder.