Conference
Effect of corticosteroid injections, comprehensive physiotherapy, and combined treatment on shoulder outcomes in patients with subacromial pain syndrome
المستخلص
Objective: Corticosteroid injection (CI) and comprehensive physiotherapy (CP) are two most common treatment methods to treat subacromial pain syndrome (SAPS), however, sole effectiveness of each method or in combination is in doubt yet.
Design: A double-blind 3×4 randomized controlled trial
Participants: 75 participants with unilateral SAPS
Intervention: Random assignment with allocation concealment into three groups labeled as 12 sessions, supervised CP (n=25), 1cc triamhexal CI (n=25), and 1cc triamhexal CI combined with 12 sessions, supervised CP (n= 25).
Outcomes: Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI), shortened Disabilities of Arm, Shoulder and Hand (Quick-DASH), and Western Ontario Rotator Cuff Index (WORC). Outcomes were gathered pre- and post-intervention, with three- and six-month follow-ups
Results: seventy-five SAPS patients (45 female and 30 male) participated (46.36±11.97). The results of 3×4 repeated measure deign revealed that there were interactions of group-in-time for Quick-DASH (p= 0.02, effect size (ES) = 0.81), SPADI (p= 0.05, ES= 0.75), and WORC (p= 0.007, ES=0.90) parameters but not for VAS (p=0.81). Post hoc analysis stated that there was a difference between physiotherapy and CI group in terms of Quick-DASH (p= 0.003, mean= 12.04), SPADI (p= 0.009, mean= 10.79), and WORC (p=0.002, mean= 12.09). The results of pairwise comparison revealed that pre-test data were significantly different with data of post-test and follow-ups (p0.05).
Conclusion: CP and CP combined with CI results in statistically significant and potentially clinically important difference in function and quality of the life at all timeframe compared with CI. Moreover, there was no between group difference in order to reduce pain. CP combined with CI might be considered for patients needing a quick improvement, but intermediate (12 to 26 weeks) worsening of symptoms makes the treatment difficult to recommend.
Keywords: subacromial impingement syndrome, physiotherapy, corticosteroid injection
Design: A double-blind 3×4 randomized controlled trial
Participants: 75 participants with unilateral SAPS
Intervention: Random assignment with allocation concealment into three groups labeled as 12 sessions, supervised CP (n=25), 1cc triamhexal CI (n=25), and 1cc triamhexal CI combined with 12 sessions, supervised CP (n= 25).
Outcomes: Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI), shortened Disabilities of Arm, Shoulder and Hand (Quick-DASH), and Western Ontario Rotator Cuff Index (WORC). Outcomes were gathered pre- and post-intervention, with three- and six-month follow-ups
Results: seventy-five SAPS patients (45 female and 30 male) participated (46.36±11.97). The results of 3×4 repeated measure deign revealed that there were interactions of group-in-time for Quick-DASH (p= 0.02, effect size (ES) = 0.81), SPADI (p= 0.05, ES= 0.75), and WORC (p= 0.007, ES=0.90) parameters but not for VAS (p=0.81). Post hoc analysis stated that there was a difference between physiotherapy and CI group in terms of Quick-DASH (p= 0.003, mean= 12.04), SPADI (p= 0.009, mean= 10.79), and WORC (p=0.002, mean= 12.09). The results of pairwise comparison revealed that pre-test data were significantly different with data of post-test and follow-ups (p0.05).
Conclusion: CP and CP combined with CI results in statistically significant and potentially clinically important difference in function and quality of the life at all timeframe compared with CI. Moreover, there was no between group difference in order to reduce pain. CP combined with CI might be considered for patients needing a quick improvement, but intermediate (12 to 26 weeks) worsening of symptoms makes the treatment difficult to recommend.
Keywords: subacromial impingement syndrome, physiotherapy, corticosteroid injection
الكلمات المفتاحية
subacromial impingement syndrome
physiotherapy
corticosteroid injection
