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Effectiveness of diacutaneous fibrolysis for the treatment of subacromial impingement syndrome: a randomised controlled trial |
Barra Lopez ME, Lopez de Celis C, Fernandez Jentsch G, Raya de Cardenas L, Lucha Lopez MO, Tricas Moreno JM |
Manual Therapy 2013 Oct;18(5):418-424 |
clinical trial |
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
Our objective was to assess the effectiveness of diacutaneous fibrolysis on pain intensity, range of motion and functional status in patients suffering from subacromial impingement syndrome. A randomised controlled trial was conducted in two Spanish National Health Service Primary Health Care Centres. Participants (n = 120) were randomly assigned to one of three groups (intervention, placebo or control groups). All three groups received a protocolised treatment based on therapeutic exercises, analgesic electrotherapy and cryotherapy. Additionally, the intervention group received six sessions of diacutaneous fibrolysis treatment; the placebo group received six sessions of sham diacutaneous fibrolysis treatment, while the control group received only the protocolised treatment. Pain intensity, available active range of motion and function were measured pre-treatment, post-treatment, and at a three-month follow-up. At the post-treatment assessment, differences between intervention and control groups were statistically significant or clinically relevant in function, flexion, extension and external rotation movements. Differences between placebo and control groups were significant only in extension movement. No significant differences were found in pain intensity. At the 3 month follow-up assessment, between-groups differences were not statistically significant and clinical relevance was achieved only for external rotation movement between intervention and control groups. At the post-treatment assessment 89% of the participants in the intervention group, 76% of the participants in the placebo group and 67% of the participants in the control group reported subjective improvement (p < 0.01). In conclusion, adding Diacutaneous Fibrolysis to the conservative treatment of Subacromial Impingement Syndrome improves function and external rotation movements and also gives significantly higher patient satisfaction.
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