Effects of mulligan and proprioceptive neuromuscular facilitation on pain, function and quality of life in subacromial impingement syndrome

Objective: The purpose of the study was to investigate the effects of PNF and Mulligan methods on pain, upper extremity functionality and quality of life in patients with Subacromial Impingement Syndrome (SIS) and to compare the differences between the effects two methods.Method: This study was carried out on 40 patients (26 females, 14 males), mean aged 50,3±1,13 years, who had been diagnosed as SIS admitted to the physical therapy and rehabilitation clinic in Private Balçova Physical Therapy and Rehabilitation Center. Before the treatment, patients were separated into 2 groups using table of random numbers. Standard physical therapy and PNF were applied to Group I (n=20); and standard physical therapy with Mulligan technique were applied to Group II (n=20). All the treatments were performed for 5 sessions in a week, 20 sessions in total. Pain, upper extremity functionality (Constant Shoulder Score) and quality of life (SF-36) measurement were evaluated. The measurements were repeated at the end of the treatment and 3 months later.Results: Before treatment, demographic information, pain severity, Constant Shoulder Score and SF-36 quality of life scores were similar in groups and there was no statistically difference between groups (p>0.05). It?s determined that pain severity decreased, Constant Shoulder Score improved after treatment and also 3 months later in both groups and there was a statistically significant difference when these values compared with those before treatment (p<0.05). Physical component and mental component scores of SF-36 significantly increased in Group 1 (p<0.05). In Group II mental component score of SF-36 didn?t significantly increase (p>0.05). When the measurements of groups which performed after treatment and at the end of the 3. month compared, similar changes for pain severity, Constant Score and quality of life scores were seen showing no statistically significant difference (p>0.05).Conclusion: The results of our study showed that PNF or Mulligan techniques in addition to a standard physical therapy program is effective for decreasing shoulder pain and increasing functional level of upper extremity and quality of life in the treatment of SIS and these effects are lasted even at the 3.month. Additionally, it is found that the improvements due to PNF or Mulligan techniques were similar.Key words: Subacromial impingement syndrome, PNF, Mulligan concept, Shoulder pain, Functional level, Quality of life