Manuel Tedavi ve Proprioseptif Nöromusküler Fasilitasyon Etkniklerinin Adeziv Kapsülitli Hastalarda Eklem Hareket Açıklığı, Ağrı ve Fonksiyonlar Üzerine Olan Etkileri

Abstract

This study was performed to compare the effectiveness of manuel treatment (MT) and Proprioceptive Neuromuscular Fasilitation Techniques (PNF) on pain, range of motion (ROM), scapular dyskinesis, shoulder functions, health quality and general health assessment. 30 patients aged between 35-65 years diagnosed adhesive capsulitis were participated in the study. Patients were divided into two groups as MT Group (n=16) and PNF Group (n=14) using stratified randomization. Both Groups were treated by classical physiotherapy program (hotpack and ultrasound) for a total of 8 weeks, 3 days per week and were advised Wand Exercise as a home program. İn addition to this, MT was applied for the MT Group; PNF was applied for the PNF Group. Patients in both group were registered about physical characteristics and were assessed pain intensity level (VAS), range of motion (goniometer), muscle strenght (digital dynomometer), scapular dyskinesis (measuring tape). “Simple Shoulder Test (SST)”, “Shoulder Pain and Disability İndex (SPADI)”, “Disabilities of the Arm, Shoulder and Hand (DASH)”, were used to assess shoulder functions. “Health Organization Quality of Life Instrument (EUROHİS-QOL)” and “Health Survey (SF-36)” were used for health quality and “Health Assessment Questionnaire” was for assesing general health. Abduction, external and internal range of motion, pain intensity level, muscle strenght, shoulder functions, pain and physical functions parameters of health quality which is related with health (SF-36) showed significant improvements in the MT Group after the treatment (p<0.05). In the PNF Group, shoulder functions exception of SPADI disability score, ROM in flexion and abduction, pain severity level, muscle strenght, pain and social function parameter of health quality which is related with health (SF-36) were provided significant improvements (p<0.05). In comparison of the groups, external rotation was in favor of MT Group; EUROHIS-QOL was in favor of PNF Group (p<0.05). There was no differences in scapular dyskinesis, health quality score which is unrelated with health (EUROHIS-QOL) and general health status between the groups after the treatment (p>0.05). In groups comparison, range of motions exception of the external rotation, pain severity level, muscle strenght, scapular dyskinesis, shoulder functions and general health status were found not statistically different (p>0.05). As a result, we decided that it will be more effective to combine both techniques because MT provided larger external rotation ROM that limits shoulder functions and gives difficulties to regain in physiotherapy of adhesive capsulitis, whereas health quality which is unrelated with health improved more using PNF. Key Words: Adhesive capsulitis, proprioceptive neuromusculer fasilitation (pnf), manuel treatment, physiotherapy and rehabilitation