The clinical effect of water-based exercise programme in patients with subacromial impingement syndrome

Purpose: To compare the clinical effect of land-based and water-based exercise programme in patients with subacromial impingement syndrome.Methods: Seventy shoulders were randomized to water-based (n=35) or land-based (n=35) exercise programme. The intervention in the water-based exercise group consisted of hotpack, TENS, US and exercise in the water and in the land-based exercise group consisted of hotpack, TENS, US and land-based exercises. The measurement was performed after the treatment and at the third month.Clinical outcome measures included pain, range of motion, spesific shoulder tests, SPADI and WORC index.Student T test, Mann Whitney U test, chi-square test, Fisher test, Repeated Measures test and Cochran-Q test analyses were used for statistical analyses.Results: There was no significant difference between the two groups at baseline for any of the demographic characteristics. The pain reduction in the both group was statistically meaningful at the first control but no difference in pain was observed for any of the groups. A significant reduction in pain at 3 months follow-up was observed in the water-based exercise group compared with the land-based exercise group. The range of motion was increased in both group at the second and third measurement and there was significant difference in the water-based exercise group for internal rotation. There was a significant difference in the water-based exercise group for reduction positive Hawkins test and Supraspinatus test. There was a significant reduction in the positive results for the Neer, painful arc, Speed, Yergason?s and Zero-Degree abduction tests for both groups.We found more statistical recuperation in the water-based exercise group for SPADI and WORC index at the third control.Conclusion: Accordingly to these results; the water-based exercise groups showed more improvement in pain and functional capacity of the shoulder. The water-based exercise programs and physical therapy combination can be good alternative for the treatment of the subacromial impingement syndrome. There is a need for more prospective randomized double-blind controlled trials.