Abstract
Objective
To evaluate the effects of pulsed electromagnetic field (PEMF) and exercises in reducing
pain and improving function and muscle strength in patients with shoulder impingement
syndrome (SIS).
Design
Double-blind, randomized controlled trial with a 3-month posttreatment follow-up.
Setting
Outpatient rehabilitation of a public hospital.
Participants
Patients (N=56) between 40 and 60 years of age, with a diagnosis of SIS, were randomly
assigned to receive active PEMF (n=26; mean age, 50.1y) or placebo PEMF (n=30; mean
age, 50.8y).
Interventions
After 3 weeks of active or placebo PEMF, both groups performed the same program of
exercises that focused on shoulder strengthening.
Main Outcome Measures
A visual analog scale, the University of California/Los Angeles shoulder rating scale,
the Constant-Murley shoulder score, and handheld dynamometry for muscle strength were
used as outcome measures at baseline (pretreatment), at 3 weeks (after active or placebo
PEMF), at 9 weeks (postexercise), and at 3 months posttreatment.
Results
Patients in the active PEMF group had a higher level of function and less pain at
all follow-up time frames compared with baseline (P<.05). However, the placebo PEMF group had increased function and reduced pain only
at the 9-week and 3-month follow-ups (P<.05)—that is, after performing the associated exercises. For the shoulder dynamometry,
the active PEMF group had increased strength for lateral rotation at 9 weeks (P<.05), and increased strength for medial rotation at 9 weeks and 3 months (both P<.05) when compared with baseline. There was no significant difference for shoulder
strength in the placebo PEMF group (P>.05), as well as no significant differences (P>.05) for all outcome measures.
Conclusions
The combination of PEMF and shoulder exercises is effective in improving function
and muscle strength and decreasing pain in patients with SIS. However, these results
should be carefully interpreted because of the lack of differences between groups.
Keywords
List of abbreviations:
ICC (intraclass correlation coefficient), MCID (minimal clinically important difference), PEMF (pulsed electromagnetic field), SIS (shoulder impingement syndrome), VAS (visual analog scale), UCLA (University of California/Los Angeles)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Screening the athlete's shoulder for impingement symptoms: a clinical reasoning algorithm for early detection of shoulder pathology.Br J Sports Med. 2008; 42: 628-635
- Shoulder impingement syndrome: correlations between clinical tests and ultrasonographic findings.Ortop Traumatol Rehabil. 2009; 11: 120-126
- Subacromial space width changes during abduction and rotation: a 3-D MR imaging study.Surg Radiol Anat. 1999; 21: 59-64
- Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report.J Bone Joint Surg Am. 1972; 54: 41-50
- Upper limb motor strategies in persons with and without shoulder impingement syndrome across different speeds of movement.Clin Biomech (Bristol, Avon). 2008; 23: 1227-1236
- Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up.Ann Rheum Dis. 2005; 64: 760-764
- Progressive resistance training in patients with shoulder impingement syndrome: a randomized controlled trial.Arthritis Rheum. 2008; 59: 615-622
- Effects of local microwave diathermy on shoulder pain and function in patients with rotator cuff tendinopathy in comparison to subacromial corticosteroid injections: a single-blind randomized trial.J Orthop Sports Phys Ther. 2012; 42: 363-370
- Pulsed electromagnetic energy treatment offers no clinical benefit in reducing the pain of knee osteoarthritis: a systematic review.BMC Musculoskelet Disord. 2006; 7: 51
- Therapeutic uses of pulsed magnetic-field exposure: a review.Radio Sci Bull. 2003; 307: 9-32
- Pulsed electromagnetic fields increase growth factor release by nonunion cells.Clin Orthop Relat Res. 2001; 384: 265-279
- Pulsed magnetic field therapy for osteoarthritis of the knee: a double-blind sham-controlled trial.Wien Klin Wochenschr. 2002; 114: 678-684
- Extremely low frequency magnetic fields (ELFMF) and pain therapy.in: Lin J.C. Advances in electromagnetic fields in living systems. Vol 4. Springer, New York2005: 155-187
- Pulsed magnetic and electromagnetic fields in experimental Achilles tendonitis in the rat: a prospective randomized study.Arch Phys Med Rehabil. 1997; 78: 399-404
- Pulsed magnetic field therapy increases tensile strength in a rat Achilles' tendon repair model.J Hand Surg [Am]. 2006; 31: 1131-1135
- Clinical effectiveness of magnetic field therapy: a review of the literature.Acta Med Austriaca. 2000; 27: 61-68
- Exposure to a specific pulsed low-frequency magnetic field: a double-blind placebo-controlled study of effects on pain ratings in rheumatoid arthritis and fibromyalgia patients.Pain Res Manag. 2006; 11: 85-90
- Therapeutic effect of pulsed electromagnetic field in conservative treatment of subacromial impingement syndrome.Clin Rheumatol. 2007; 26: 1234-1239
- Systematic review of randomized controlled trials of interventions for painful shoulder: selection criteria, outcome assessment, and efficacy.BMJ. 1998; 316: 354-360
- Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome.J Orthop Sports Phys Ther. 2000; 30: 126-137
- Impingement lesions.Clin Orthop Relat Res. 1983; 173: 70-77
- Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol.J Shoulder Elbow Surg. 2009; 18: 138-160
- Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scales (VAS) measuring pain in patients treated for rotator cuff disease.J Shoulder Elbow Surg. 2009; 18: 927-932
- A clinical method of functional assessment of the shoulder.Clin Orthop Relat Res. 1987; 214: 160-164
- Repair of the rotator cuff. End-result study of factors influencing reconstruction.J Bone Joint Surg Am. 1986; 68: 1136-1144
- Tradução e adaptação cultural do Modified-University of California at Los Angeles shoulder rating scale para a lingual portuguesa.Rev Bras Reumatol. 2006; 46: 246-252
- Reliable change and minimum important difference (MID) proportions facilitated group responsiveness comparisons using individual threshold criteria.J Clin Epidemiol. 2004; 57: 1008-1018
- Isokinetic and isometric measurement of strength of external rotation and abduction of the shoulder.J Bone Joint Surg Am. 1992; 74: 1320-1333
- The impact of rotator cuff pathology on isometric and isokinetic strength, function, and quality of life.J Shoulder Elbow Surg. 2004; 13: 593-598
- Força do manguito rotador em indivíduos com síndrome do impacto comparado ao lado assintomático.Acta Ortop Bras. 2011; 19: 333-337
- Effect of low frequency pulsing electromagnetic fields on skin ulcers of venous origin in humans: a double-blind study.J Orthop Res. 1990; 8: 276-282
- Low-frequency pulsed electromagnetic field therapy in fibromyalgia: a randomized, double-blind, sham-controlled clinical study.Clin J Pain. 2009; 25: 772-778
- Pulsed short wave effect in pain and function in patients with knee osteoarthritis.J Appl Res. 2008; 8: 189-198
- Pulsed shortwave treatment in women with knee osteoarthritis: a multicenter, randomized, placebo-controlled clinical trial.Phys Ther. 2011; 91: 1009-1017
- Pulsed electromagnetic fields to reduce diabetic neuropathic pain and stimulate neuronal repair: a randomized controlled trial.Arch Phys Med Rehabil. 2009; 90: 1102-1109
- Pulsed electromagnetic field therapy of persistent rotator cuff tendonitis: a double-blind controlled assessment.Lancet. 1984; 323: 695-698
Article info
Publication history
Published online: October 17, 2013
Footnotes
Clinical Trial Registration No.: NCT01452204.
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
