Effects of Muscle Energy Technique versus Shoulder Mobilization on Pain and Function in Patients with Subacromial Pain Syndrome

Abstract

Background Subacromial pain syndrome is most leading cause of disability that includes the wide spectrum of disorders including subacromial tendinopathy, partial or full thickness tear of rotator cuff and subacromial bursitis. The manual therapy interventions for this condition are still debatable.

Aim To evaluate the comparative effects of muscle energy technique (MET) versus posterior shoulder mobilization with movement (MWM) on pain, function and shoulder range of motion in patients with subacromial pain syndrome.

Method Patients diagnosed with subacromial pain syndrome were recruited in this pragmatic parallel double blinded randomized clinical trial. The sample was selected through non-probability convenient sampling technique. Forty patients out of 56 meeting the eligibility criteria were equally divided into two groups, MET group (n = 20) and MWM group (n = 20), through a randomization web service. Data were collected at baseline and after successful completion of a six week trial treatment. Pain severity was measured by using a numeric pain rating scale, shoulder disability was measured by using the Shoulder Pain and Disability Index (SPADI) and ranges of motion were measured by using goniometry. Data was analyzed through SPSS 24.

Results Outcome measures including pain, disability and shoulder range of motion were significantly (p ≤ 0.05) improved in both groups after the intervention. When comparing both groups, pain score was U = 82.0 (p ≤ 0.001) and disability score was t = –2.913 (p ≤ 0.006) favoring MET.

Conclusion Both MET and MWM were effective for symptomatic management in this sample of 40 patients with subacromial impingement syndrome. MET seems to show some superior effects as compared to MWM.

Zusammenfassung

Hintergrund Das subakromiale Schmerzsyndrom ist die häufigste Ursache für Behinderungen und umfasst ein breites Spektrum an Erkrankungen, darunter subakromiale Tendinopathie, teilweiser oder vollständiger Riss der Rotatorenmanschette und subakromiale Schleimbeutelentzündung. Die manuellen Therapieinterventionen für diese Erkrankung sind immer noch umstritten.

Ziel Untersuchung und Bewertung der Auswirkungen der Muskelenergietechnik (MET) im Vergleich zur hinteren Schultermobilisierung mit Bewegung (MWM) auf Schmerzen, Funktion und den Bewegungsradius der Schulter bei Patient*innen mit subakromialem Schmerzsyndrom.

Methode Für die pragmatische, parallele, doppelt verblindete, randomisierte klinische Studie wurden Patient*innen mit diagnostiziertem subakromialem Schmerzsyndrom rekrutiert. Die Stichprobe wurde mithilfe eines Nicht-Wahrscheinlichkeits-Stichprobenverfahrens ausgewählt. 40 der 56 Patient*innen, die die Zulassungskriterien erfüllten, wurden über einen Randomisierungs-Webdienst zu gleichen Teilen in 2 Gruppen aufgeteilt: die MET-Gruppe (n = 20) und die MWM-Gruppe (n = 20). Die Daten wurden zu Studienbeginn und nach erfolgreichem Abschluss einer 6-wöchigen Probebehandlung erhoben. Die Schmerzintensität wurde mithilfe einer numerischen Schmerzbewertungsskala gemessen, die Schulterbehinderung mithilfe des Shoulder Pain and Disability Index (SPADI) und der Bewegungsumfang mithilfe der Goniometrie gemessen. Die Daten wurden mit SPSS 24 analysiert.

Ergebnisse Ergebnisparameter wie Schmerzen, Behinderung und Schulterbewegungsumfang verbesserten sich in beiden Gruppen nach der Intervention signifikant (p ≤ 0,05). Beim Vergleich beider Gruppen betrug der Schmerzscore U = 82,0 (p ≤ 0,001) und der Behinderungsscore t = –2,913 (p ≤ 0,006) zugunsten von MET.

Schlussfolgerung Sowohl MET als auch MWM waren zur symptomatischen Behandlung der Stichprobe von 40 Patient*innen mit subakromialem Schmerzsyndrom wirksam. MET scheint im Vergleich zu MWM eine überlegene Wirkung zu zeigen.

Key words

muscle energy technique - mulligan mobilization - shoulder disability - shoulder mobilization - shoulder pain syndrome

Schlüsselwörter

Muskelenergietechnik - Mulligan-Mobilisierung - Schulterbehinderung - Schultermobilisierung - Schulterschmerzsyndrom

Publikationsverlauf

Eingereicht: 25. März 2023

Angenommen: 06. Juni 2023

Artikel online veröffentlicht:
26. Juli 2023

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