Effect of PRP With Physiotherapy on Shoulder Impingement

Summary

Background Shoulder impingement syndrome is the most common disorder of the shoulder. Study results on the effectiveness of treatment options are inconclusive and limited. Therefore, more evidence is needed for long-term results Objective To investigate the effectiveness of the ideal physiotherapy protocol (IPRP-PT) applied after platelet-rich plasma (PRP) injection on pain and functionality in patients with shoulder impingement syndrome, and to propose an alternative treatment protocol.

Methods The study was performed in 54 patients with shoulder impingement syndrome who were injected with PRP. Patients were randomly divided into two equal groups. For 21 days, the study group received IPRP-PT study protocol, conventional physiotherapy and home exercise programme, while the control group received only conventional physiotherapy programme. Normal range of motion, muscle strength and posture were assessed. In addition, short form Mc-gill (SF-MPQ), Visual Analogue Scale (VAS), Constant Murley Shoulder Score, Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA), were used.

Conditions

• Functionality
• Shoulder Impingement Syndrome
• Platelet-Rich Plasma

Interventions

DRUG

Platelet Rich Plasma (PRP)

All patients included in the study were educated about the correct posture in daily life, sleeping position, and the things to be followed to improve the quality of life. In addition to 2 cc anticoagulant citrate dextrose withdrawn syringe, 20 cc of blood was taken by the nurse from the patients diagnosed with shoulder impingement syndrome. After the blood was transferred to a special PRP kit and centrifuged at 4000 rpm for 8-9 minutes, the platelet-rich plasma portion remaining at the top of the kit was taken into the syringe and applied to the 1/3 posterolateral 1/3 of the glenohumeral joint by the physician. After PRP injections, evaluations of the study and control groups were performed before and after 21 days of treatment. The study group received IPRP-PT study protocol, conventional physiotherapy and home exercises, while the control group received only conventional physiotherapy and home programme.

OTHER

Conventional physiotherapy programme

It was applied once a day for 21 days to 54 patients included in the study. Ultrasound; Enraf Nonius Sonopuls692V® device was applied around the glenohumeral joint with an average treatment dose of 3 MHz, N 1.5 w/cm² and 8 minutes. Transcutaneous Electrical Nerve Stimulation (TENS); Enraf Nonius Sonopuls 692V® device was applied to the glenohumeral joint with a frequency between 60-120 Hz and a transition time of 50-100 µsec for 20 min. Hot Pack; It was applied to the glenohumeral joint for 20 minutes (Kuhn, 2009; Kul and Ugur, 2019; Walsh, Howe, Johnson, and Sluka, 2009).

OTHER

IPRP-PT Study Protocol

IPRP-PT study protocol was applied in addition to conventional physiotherapy for 21 days in 27 patients who underwent PRP injection in our study group. The exercises were performed once a day with a physiotherapist and twice a day at home. The exercises performed were as follows; posterior capsule stretching; wand exercise; scapulatoracic (st), acromioclavicular (ac) and sternoclavicular (sc) joint mobilisation; GH joint posterior, anterior, inferior sliding; GH joint distraction; deep friction massage of the tendon of the supraspinatus muscle; kinesiological taping; isometric and isotonic strengthening exercises; proprioceptive neuromuscular facilitation exercises (pnf); closed kinetic ring and proprioception exercises

Sponsors & Collaborators

• Istinye University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

30 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-07-15

Primary Completion

2020-03-20

Completion

2020-07-30

Countries

• Turkey (Türkiye)

Study Locations