Capacitive resistive monopolar radiofrequency at 448 kHz plus exercising versus exercising alone for subacromial pain: A sham-controlled randomized clinical trial.

OBJECTIVE: To investigate the effectiveness of thermal and sub-thermal capacitive-resistive monopolar radiofrequency at 448 kHz plus exercising compared to sham radiofrequency plus exercising on pain, functionality, and quality of life in patients with subacromial pain. DESIGN: Randomized, controlled, parallel, double-blind, three-arm clinical trial. SETTING: Hospital and Primary Care. SUBJECTS: Eighty-one participants with subacromial pain in three intervention groups. INTERVENTIONS: Three interventions with capacitive-resistive radiofrequency (thermal, sub-thermal, and sham) over 9 sessions (3 per week) plus an exercising protocol identical for all groups over 15 sessions (5 per week). OUTCOME MEASURES: Visual analogue scale and pressure pain threshold for pain, Shoulder Pain and Disability Index and Quick-Disabilities of the Arm, Shoulder and Hand for functionality, and quality of life via the European Quality of Life-Five Dimensions were assessed at baseline, immediately posttreatment, and 1 month and 3 months post-intervention. RESULTS: No between-group differences were found in the pain visual analogue scale (F = 1.0; P = 0.37), Shoulder Pain and Disability Index (F = 1.0; P = 0.36), European Quality of Life-Five Dimensions (F = 0.76; P = 0.47), and pressure pain (F = 0.14; P = 0.86) outcomes, with a statistical power < 0.30 for all comparisons. Between-group differences were found in the Quick-Disabilities of the Arm, Shoulder and Hand (F = 3.4; P < 0.038), with an improvement of -14.1 points (confidence interval at 95% (95% CI) -28.1 to -0.1) in the thermal versus the sham group at 1 month follow-up. The mobility dimension of European Quality of Life-Five Dimensions improved in a greater proportion of participants in the thermal group (22.2% thermal, 7.4% sub-thermal, and 0.0% sham; P = 0.02). CONCLUSION: Adding thermal radiofrequency to exercising can further improve slightly functionality and mobility in people with subacromial pain in the short term, but not pain perception. Future studies with larger sample sizes are warranted to increase statistical power.

[Health-related quality of life in patients diagnosed with subacromial syndrome in the Talavera Integrated Area]. / Calidad de vida relacionada con la salud en los pacientes diagnosticados de síndrome subacromial en el Área Integrada de Talavera.

OBJECTIVE: There is a high prevalence of subacromial syndrome among patients with shoulder pathology, where the pain and tendency to chronification are some of its most important characteristics. This is why it is necessary to objectively interact with the quality of life of the subject. The main goal was to determine if there are differences between subacromial patients and asymptomatic patients regarding quality of life. METHODS: Transversal study carried out in the Talavera Integrated Area during the months of November 2016 to March2017. Participated a total of 92 subjects, 46 were symptomatic mating by age and sex with an asymptomatic sample and without joint pathology of the same size and health area. In both cases, the EQ-5D questionnaire was administered. The prevalence was calculated from the waiting list of traumatology physiotherapy in the year 2015. The SPSS statistical program was used, applying the T-test and the chi-square. RESULTS: The EQ-5D questionnaire obtained a standardized mean of 0.70 in the subacromial syndrome and 0.85 in the asymptomatic population (P=0.0001). The prevalence of impingement subacromial within shoulder pathology was 39.19%. CONCLUSIONS: Subacromial syndrome has a high prevalence within the shoulder pathology in the Rehabilitation Service and significantly interferes in the quality of life related to the health of the subject.

OBJETIVO: Existe una alta prevalencia del síndrome subacromial dentro de los pacientes con patología de hombro, en el cual el dolor y la tendencia a la cronificación son alguna de sus características más importantes. Por ello es necesario objetivar su interacción con la calidad de vida del sujeto. El objetivo principal del estudio fue determinar si existían diferencias en la calidad de vida entre sujetos con síndrome subacromial y asintomáticos. METODOS: Se realizó un estudio transversal en el Área Integrada de Talavera de la Reina (Toledo), durante los meses de noviembre de 2016 a marzo de 2017. Participaron un total de 92 sujetos, de los que 46 eran sintomáticos, apareándose por edad y sexo con una muestra asintomática y sin patología articular del mismo tamaño y área de salud. En ambos casos se les administró el cuestionario EQ-5D. La prevalencia se calculó a partir de la lista de espera de fisioterapia traumatológica del año 2015. Se utilizó el programa estadístico SPSS, empleándose la prueba T y la chi-cuadrado. RESULTADOS: El cuestionario EQ-5D obtuvo una media estandarizada de 0,70 en el síndrome subacromial y de 0,85 en la población asintomática (p=0,0001). La prevalencia del impingement subacromial dentro de la patología de hombro fue del 39,19%. CONCLUSIONES: El síndrome subacromial tiene una alta prevalencia dentro de la patología de hombro en el Servicio de Rehabilitación e interfiere significativamente en la calidad de vida relacionada con la salud del sujeto.