Rodica Ungur

The role of isokinetic exercises in the rehabilitation of patients with impingement syndrome of the shoulder

Background. Scapulohumeral periarthritis is a medical condition consisting of the inflammation of tendinomuscular structures of the shoulder, causing pain, limited mobility, functional impotence and reduced quality of life. Aims. The study aimed to demonstrate the effectiveness of active kinesiotherapy programs combined with isokinetic exercises in improving the symptoms of patients presenting with scapulohumeral periarthritis. Methods. The study was conducted on a number of 30 patients diagnosed with simple shoulder pain, mixed shoulder pain or subacromial-deltoid impingement syndrome. The subjects were divided into two groups. The reference group, consisting of 15 patients, was subjected to an active kinesiotherapy program, as well as an active endurance one. The study group, also comprising 15 patients, was subjected to the same kinesiotherapy program, combined with isokinetic exercises. In order to objectify the results, assessment tests were performed on days 1 and 10 of treatment. These included the VAS (visual analog scale) for pain intensity, the flexion-abduction-external rotation articular test, and the Constant-Murley shoulder test. Results. On day 1 of treatment, the symptoms and levels of pathology observed among the two groups were similar. The study was performed on groups of homogeneous sex and age, ranging between 60 and 70 years. As per the VAS, the average pain intensity was measured at 5.8 among patients in the reference group and 5.7 among patients in the study group. On day 10 of treatment, the test indicated a reduction in the pain levels of both groups, the average pain intensity being measured at 2.2 and 1.6, respectively. In terms of the Constant-Murley scores, they were similar on day 1 of treatment and registered as 57.6 and 63.1, respectively, on day 10 of treatment. The articular test revealed an improvement in the range of motion of patients in the study group by 4% on flexion, 5% on abduction and 4% on external rotation as compared to patients in the reference group. The T-test results were statistically significant as regards the VAS (p<0.006), the Constant-Murley test (p<0.02), abduction (p<0.03), external rotation (p<0.005), and at the limit in terms of flexion (0<0.05). Conclusions. The active kinesiotherapy program combined with kinetic exercises ensures better outcomes in terms of pain relief, improved joint mobility, muscle rebalancing and, implicitly, improved quality of life among patients.