Evaluation of the effectiveness of three physiotherapeutic treatments for subacromial impingement syndrome: a randomised clinical trial

ObjectiveTo determine whether dexketoprofen administered by phonophoresis or iontophoresis is more effective for the treatment of subacromial impingement syndrome (SIS) than conventional ultrasound therapy.DesignRandomised clinical trial.SettingUniversity hospital.ParticipantsNinety-nine participants with SIS without a complete tear of the rotator cuff were assigned at random to three intervention groups.Intervention groupsParticipants received ultrasound (n = 32), phonophoresis with dexketoprofen (50 mg/session) (n = 33) or iontophoresis with dexketoprofen (50 mg/session) (n = 34). All participants completed 20 treatment sessions plus exercise therapy and cryotherapy.Outcome measuresA visual analogue scale (VAS), the Constant-Murley Scale (CMS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were administered pre-treatment (baseline), post-treatment and 1 month post-treatment.ResultsAt baseline, there were no differences between the groups. Post-treatment, VAS score improved by −1.2 points and CMS score improved by 8.9 points in the ultrasound group compared with the iontophoresis group [95% confidence interval (CI) −0.2 to −2.2 and 95% CI 17.0 to 0.7, respectively]. CMS score improved by 7.1 points in the phonophoresis group compared with the iontophoresis group (95% CI 14.8 to −0.7). At 1 month post-treatment, no significant differences were detected between the groups. VAS, CMS and DASH scores of all groups improved post-treatment and at 1 month post-treatment.ConclusionUltrasound, iontophoresis with dexketoprofen and phonophoresis with dexketoprofen can improve pain, shoulder function, and physical functioning and symptoms in the upper limb in patients with SIS without a complete tear of the rotator cuff.Clinical Trials.gov registration numberNCT01748188.