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Water-based versus land-based exercise program for the management of shoulder impingement syndrome
Subasi V, Toktas H, Demirdal US, Turel A, Cakir T, Kavuncu V
Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi [Turkish Journal of Physical Medicine and Rehabilitation] 2012;58(2):79-84
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: In this study, we aimed to compare the clinical effect of landbased and water-based exercise programs in patients with subacromial impingement syndrome. MATERIALS AND METHODS: Seventy shoulders were randomized to waterbased (n = 35) or land-based (n = 35) exercise program. The intervention in the water-based exercise group consisted of hot pack, transcutaneous electrical nerve stimulation (TENS), ultrasound (US) and exercise in the water; and in the land-based exercise group, consisted of hot pack, TENS, US and land-based exercises. The measurement was performed after the treatment and 3 months after the beginning of the treatment. We used visual analog scale (VAS) for pain assessment and shoulder function was measured with the Shoulder Pain and Disability Index and the Western Ontario Rotator Cuff Index. RESULTS: Patient demographics and baseline values were similar for both groups. The pain reduction in both groups was statistically significant at the first follow-up. A significant reduction in pain at second follow-up was observed in the water-based exercise group compared with the land-based exercise group. We found statistically significant recuperation in both groups for functional index and more recuperation in the water-based exercise group at the second follow-up. CONCLUSION: A greater improvement in pain and functional capacity was achieved with combination of physical therapy and water-based exercise program in patients with subacromial impingement syndrome.

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