Analysis of the conservative treatment efficacy in patients with subacromial impingement syndrome

Abstract


Purpose: to evaluate the efficacy of the conservative treatment of patients with subacromial impingement syndrome (SIS) and supraspinatus muscle tendon (SMT) pathology using optimized clinical and beam algorithm. Patients and methods. Complex evaluation of the conservative treatment efficacy (physiotherapeutic treatment (PHT), exercise therapy (ET), shockwave therapy (SWT)) was performed in 128 patients - 67 (52.3%) men, 61 (47.7%) women with SIS. Mean age of patients was 59±8 years (24 - 82 yrs), follow up period - 9.6 ±5.6 months (maximum 18 mos). All patients underwent optimized complex clinical and beam examination. Treatment efficacy was evaluated in dynamics at terms 3, 6 and 9 months. Dynamics of pain syndrome and structural changes in STM regress was assessed depending on the type of treatment with calculation of correlation coefficient. Results. In 3 months positive effect of conservative treatment was noted in 67 (65%), in 6 months - in 78 (77%) and in 9 months - in 84 (82%) patients. High correlation of data obtained using the elaborated pain scale for a shoulder with the visual analogue scale data at treatment monitoring (r=0,89) as well as with the monitoring US data (r=0,94) was determined. The combination of SWT+ET+PHT or SWT+PHT showed good therapeutic effect in 3 months after treatment and by 6th month excellent result was recorded in 85% of cases. Due to the long rehabilitation period in operated patients in 3 and 6 months after intervention only the satisfactory result with mean point 3.02±0.12 and 3.52±0.14 respectively was achieved. Conclusion. Choice of treatment method should be based on the results of complex clinical beam examination. In patients with SIS and SMT pathology the most effective is a combined conservative treatment with SWT+ET+PHT or SWT+PHT. However a conservative treatment efficacy is significantly influenced by the SIS stage, anatomical structure of acromeonon as well as the type of SMT structural changes.

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About the authors

Mikhail V. Emel’yanenko

Central Clinical Hospital with Outpatient Polyclinic, Administration of President of the Russian Federation

Email: mikae3@mail.ru
Moscow, Russia
Cand. med. sci., trauma and orthopaedic surgeon, Central Clinical Hospital with Outpatient Polyclinic

F. L Lazko

Central Clinical Hospital with Outpatient Polyclinic, Administration of President of the Russian Federation

Moscow, Russia

V. E Gazhonova

Central Clinical Hospital with Outpatient Polyclinic, Administration of President of the Russian Federation

Moscow, Russia

I. V Krivoshey

Central Clinical Hospital with Outpatient Polyclinic, Administration of President of the Russian Federation

Moscow, Russia

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