The effect of interferential therapy in addition to rehabilitation on pain, shoulder functions and quality of life in patients with proximal humerus fractures who were treated conservatively

Objective:The aim of this prospective, randomized, double-blind study is to examine the effect of interferential current (IF) therapy in addition to rehabilitation on pain, shoulder functions, disability, active joint range of motion (ROM), analgesic need and quality of life in patients treated conservatively for proximal humerus fractures. Materials and method: 32 patiens with proximal humerus fractures who were treated conservatively and who visited the outpatient clinic of Ege University School of Medicine, Department of Physical Medicine and Rehabilitation were enrolled in the study. The subjects were randomized into two groups, namely interference group (n=17) and placebo group (n=15) and they were included in a rehabilitation program overseen by a physiotherapist and which had a preset rehabilitation protocol, for 4 weeks, 3 days per week. In addition to this, subjects in the IF group received premodulated IF current treatment ,delivered at 100 Hz frequency, for 20 minutes. Subjects in the placebo group received sham IF for the same amount of time. All subjects were assessed at baseline and at weeks 4, 10 and 22. Results: In this study, VAS pain score, Constant score, DASH score, active ROM (shoulder flexion, extension, abduction, internal and external rotation), analgesic need and physical function, physical role, pain and social function subscores of SF-36 improved significantly in both groups (p<0,05). In intergroup analysis, IF group had better Constant scores in all visits (p<0,05). No significat difference was found between groups for VAS pain score, DASH score, active shoulder external rotation, analgesic need and physical function, physical role, pain and social function subscores of SF-36 (p>0,05). Active ROM measurements for shoulder flexion, extension and abduction was found to be significantly higher at weeks 10 and 22, and shoulder internal rotation was found to be significantly higher at all visits for the IF group (p<0,05). Discussion: IF current is used extensively for musculoskeletal problems but there is little evidence regarding its use in patients with fractures. Laboratory and clinical studies show that IF current has positive influence on fracture healing, tissue perfusion and improvement of muscle strength however none of these studies were performed on patients with proximal humerus fractures. In this study, it is seen that IF current, in addition to rehabilitation, has beneficial effects on shoulder functions and improving ROM in patients treated conservatively for proximal humerus fractures. These successful results in older patients with deplaced fractures may guide orthopaedic surgeons having difficulty deciding between conservative and surgical treatment methods. There is still need for more laboratory and clinical studies showing the effect of IF current on fractured bone tissue.