Akhtar M, Karimi H, Gilani SA, et al. The effectiveness of routine physiotherapy with and without neuromobilization on pain and functional disability in patients with shoulder impingement syndrome; a randomized control clinical trial. BMC Musculoskelet Disord. 2020 Nov 21;21(1):770. doi: 10.1186/s12891-020-03787-0. (Original study)

BACKGROUND: The objective of the study was to compare the effects of neuromobilization (NM) techniques and routine physiotherapy on pain and functional disability in patients having shoulder impingement syndrome (SIS). Present study was aimed to discover evidence based conservative and cost effective remedy on pain and functional disability.

STUDY DESIGN: Single blinded randomized control clinical trial.

METHODS: A total of 80 patients with SIS were randomly assigned into care and experimental groups (40 in each group). After the baseline assessment routine physiotherapy was executed on both groups, while NM was applied additionally to experimental group. Pain and functional disability score were evaluated by Visual Analogue Scale and University of California at Los Angeles rating score at baseline, 5th and 11th week. Differences in outcome between groups were evaluated with clinical improvement.

RESULTS: The experimental group compared with care group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% (CI), - 2.38 to - 1.25; P < 0.001 and Partial ?2 = 0.33, similarly functional disability score 28.58(27.32-29.83) vs 20.10(18.84-21.36); between group difference,5.62; 95%CI, (4.32-6.92); P< 0.001 and Partial ?2 = 0.49 respectively. In experimental group NM was a more effective technique to reduce the pain severity and disability in SIS patients as compare to care group.

CONCLUSION: Neuromobilization techniques in addition to routine physiotherapy were significantly effective for the treatment of SIS.

TRIAL REGISTRATION: IRCT20190121042445N1 , Registered 19 February 2019.

Discipline Area Score
Rehab Clinician (OT/PT) 6 / 7
Comments from MORE raters

Rehab Clinician (OT/PT) rater

The results of the current study demonstrated the improvement of pain among the two groups with SIS at 5th and 11th week. In addition, the findings of this study indicated NM has positive effects to improve UCLA score.

Rehab Clinician (OT/PT) rater

As a Physical Therapist, I find the results of this study are what I would have expected. This article is a good reminder for clinicians who may forget to include neuromobilization in the assessment and treatment of patients with SIS.
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