Impingement Shoulder Clinical Trial
Official title:
Pulsed Electromagnetic Field in Patients With Impingement Shoulder: A Randomized, Placebo-Controlled Clinical Trial
In the past many authors have reported the abnormal contact between the rotator cuff and
coracoacromial arch, but the exact etiology was not clearly understood. Thus, the objectives
of this study relate specifically to improve the symptoms and rehabilitation of shoulder
function of the patient:
1. Assess the effectiveness of magnet therapy in the treatment of impingement of the
rotator cuff;
2. Assess whether the application of magnetic therapy 3 times a week for three weeks, may
be effective as a single treatment of impingement of the rotator cuff;
3. Assess whether the combination of magnetic therapy with therapeutic exercises is more
effective than magnetic therapy only;
4. Evaluate the benefits of magnetic therapy associated with therapeutic exercise in the
short and long term.
5. Assess the effectiveness of the modulation of pulsed electromagnetic field at 25 Hz and
20 mT in patients with shoulder impingement syndrome.
1. Randomization of the patients 1.1) Duration of wash-out Having made the proper
screening of patients undergoing the study, all pre-selected patients should
discontinue any medications that might influence the symptoms of impingement syndrome
(such as analgesics, antiinflammatory, chondroprotective, etc.) for a period of 7 days.
1.2) Randomization
The investigators have chosen a total sample of 30 patients undergoing the study. Only
one will be treated the shoulders of patients, if there are cases of bilateral
impingement syndrome (IS). Patients will be equally distributed in two groups,
receiving first place:
Group 1: treatment with magnetic therapy, three times per week lasting 30 minutes each
session.
Group 2: placebo of magnet therapy (MT), three times per week lasting 30 minutes each
session.
Randomization will be done as follows: initially 10 patients will be selected to be
evaluated by a blinded evaluator and by the end of the evaluation, the patient will
randomly choose a paper folded into 2 parts, which will be inside a plastic bag. Inside
this bag there will be 10 paper folded in the same way and with the same color and
size, where in three of them will say "A", two of them written in "B", three of them
written in "C" and two of them "D" . Patients were drawn papers written "A" and "D"
will be selected for group 1 and patients to raffle papers written "B" and "C" will be
selected for group 2. After the drawing paper, the same can not be placed back in the
bag. Randomization will be done this way so that all patients can also be divided into
two groups and for the blind assessor does not know which group the patient was
allocated.
2. PLAN OF STUDY 2.1) Assessment 1: Patients selected for study are those referred to our
outpatient musculoskeletal physiotherapy with a diagnosis of impingement syndrome grade
II and grade III. All will be evaluated by a blinded investigator, who uses the Visual
Analogue Scale (VAS), the rating scale of Constant and University of California, Los
Angeles (UCLA) shoulder rating scale, and measurement of rotator cuff muscle force
(external and internal rotation) and shoulder elevation.
2.2) Assessment 2: After 3 weeks of treatment only with the applications of magneto therapy,
a new assessment will be equal to an evaluation made by an assessor blinded, who do not know
which patients are exposed to placebo or not. After the third evaluation, all patients will
continue with the sessions of magnetic therapy (placebo or not), but now associated with
specific therapeutic exercises for the treatment of impingement syndrome of the shoulder.
The assessment consists of two re-evaluation of all parameters previously in an evaluation.
2.3) Evaluation 3: The third evaluation will happen after three weeks of treatment with
magnetic therapy and exercises over again a blind assessor will evaluate patients in the
same manner as in evaluation 1 and 2. After this evaluation, patients receive high treatment
and receive a booklet of exercises to help them to practice proper exercises for the
shoulder at home.
2.4) Evaluation 4: The fourth review will occur six months after the third evaluation, where
the main objective is to evaluate the efficacy of treatment without the guidance of a
physiotherapist and without weekly applications of magnetic therapy.
- Application of methods: The investigators have chosen a total sample of 30 patients
undergoing the study. Only one will be treated the shoulders of patients, if there are
cases of bilateral impingement syndrome. Patients will be equally distributed in two
groups, receiving first place: Group 1: treatment with magnetic therapy, three times
per week lasting 30 minutes each session. Group 2: placebo of magnet therapy, three
times per week lasting 30 minutes each session.After the first 3 weeks of application
of magnetic therapy, will begin a program of therapeutic exercises (kinesiotherapy)
equally to all patients in both groups. These exercises will be conducted after each
application of magnetic therapy and all patients will receive a brochure guiding them
to perform exercises at home. The applications of magnetic therapy will continue to be
3 times per week with 30 minutes duration each application, but this time associated
with exercise, treatment will be done for another 4 weeks. After these four weeks,
patients will be reassessed by the scale of Constant and UCLA to evaluate the overall
function of the shoulders that received placebo treatment and the magneto.
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