Examination of different manual therapy technics' effects on pain, functional state, range of motion, muscle strength and life quality on patients with subacromial impingement syndrome

The aim of our study is to examine the proprioceptive neuromuscular facilitation (PNF) and myofascial release (MR) technics' effects on pain, range of motion (ROM), muscle strength, life quality and physical functionality besides conventional physiotherapy technics on patients with subacromial impingement syndrome. 30 people patricipating in the study randomly divided into two groups as PNF group and PNF with MR group. While conventional therapy is used in addition to PNF therapy, home exercise program and patient education with hold-loosening technique; in addition to all these treatments to the MR group with PNF, myofascial to the upper trapezium muscle relaxation was applied. Pain severity of the cases evalueted with VAS, ROM evaluated using goniometer, muscle strength evaluated using hand dynamometer, disability levels evaluated with shoulder pain and disability index, functional states evaluated with brief survey of arm, shoulder and hand problems and their life qualities evaluated with Nottingham Health Profile. Patients evaluated before the treatment, after the first treatment session for the aim of showing the acute effects of applications and at the end of the 10 sessions of treatment. When the data obtained from the study were analyzed; improvement was observed on shoulder pain, ROM, muscle strength, disability levels and functional states of patients in both treatment technics. Addition of myofascial release technic to treatment decreases resting pain of patients and it has been found that addition of myofascial release technic increases ROM and muscle strength in some aspects. After one session of treatment, it was concluded that PNF technic provides more improvement in terms of activity pain, MR technic provides more improvement in flexion, external rotation and internal rotation range of motion, flexion and abduction muscle strength. After 10 sessions of treatment, PNF treatment showed only improvement in quality of pain in quality of life, MR treatment showed improvment in pain, physical activity, emotional state, sleep and total aspects. According to these results, in addition to conventional treatment methods in patients with subacromial impingement syndrome, using PNF and MR treatments combined of the treatment of patients both acute and cumulative effect in positive direction. Key Words: Subacromial Impingement Syndrome, Proprioceptive Neuromuscular Facilitation, Myofascial Release, Pain