PROJECT GUIDE NAME: DR. RAJA LAXMI

G.SPERJAN

REG NO:112121103024

BPT IV YEAR

 

TO COMPARE THE EFFECTIVENESS OF KINESIO TAPING AND EXERCISE IN

PATIENTS WITH SHOULDER IMPINGMENT SYNDROME

 

INTRODUCTION

shoulder problems in general medical practice is estimated to be 1 1.2/ 1000 patients per year. Lifetime prevalence of shoulder pain has been reported to range from 7% to 36% of the population.

Shoulder impingement has been defined as compression and mechanical abrasion of rotator cuff structures as they pass beneath the coracoacromial arch during arm elevation.

It is the most common disorder of shoulder with prevalence ranging from 44% to 65%. The vast majority of people with impingement syndrome who are younger than 60 years of age relate their symptoms to occupational or athletic activities that involve frequent overuse of arm.

 

Impingement is caused due to inadequate space for clearance of rotator cuff tendons as arm is elevated. It is classified into primary shoulder impingement and secondary shoulder impingement.

 Primary shoulder impingement is due to the intrinsic

factors such as rotator cuff weakness, chronic inflammation of rotator cuff tendon or sub acromial bursa, posterior capsule tightness which leads to superior and anterior translation of humeral head. It is also may be due to extrinsic factors like hooked acromion, acromial spurs or postural dysfunction.

 

The secondary impingement is defined as relative decrease in the sub acromial space which is caused due to glenohumeral joint instability.

The supraspinatus along with other rotator cuff muscles serve to maintain the congruence between the humeral head and glenoid fossa by producing compressive force during glenohumeral movements.

Abnormal superior, anterior translations have been linked to fatigue of rotator cuff and tightness of posterior capsule. Dysfunctional and weak rotator cuff musculature have been documented in patients with shoulder impingement. 

history of kinesio taping kinesio taping is a modality treatment based on the body's own natural healing process.

the kinesio taping method exhibits its efficacy through the activation of the neurological and circulatory systems. this method basically stems from the science of kinesiology, recognizing the importance of body and muscle movement in rehabilitation and everyday life. hence the name  

 

the kinesio taping method exhibits its efficacy through the activation of the neurological and circulatory systems. this method basically stems from the science of kinesiology, recognizing the importance of body and muscle movement in rehabilitation and everyday life. hence the name "kinesio" is used. muscles attribute not only to the movement of the body, but also control the circulation of venous and lymph flows, body temperature, etc.

using an elastic tape, it was discovered that muscles and other tissues could be helped by outside assistance.

 

 

soon there after kinesio taping vas discovered by olympic volleyball players for preventative maintenance in japan and word quickly spread to other athlets. today, kinesio taping is accepted by medical practitioners and athlets in japan. the united states, europe, south america, australia and other asian countries as well.

There are various studies done on the effect of normal scapular taping and also on the effect of mobilization with movement with scapular stabilizing exercises in shoulder impingement which have been proved to be an effective treatment in reducing pain and improving ROM. 

Kinesiotaping is said to be an advanced treatment technique which has been considered in reducing pain, improving muscle function and joint proprioception.

There are very few studies conducted on the effect of kinesiotaping in shoulder impingement along with mobilization with movement technique. Therefore there is a need to study the effectiveness of mobilization with movement and kinesiotaping in improving the shoulder ROM, functional status and reducing pain in patients with shoulder impingement. 

 

A visual analogue scale (vas) is a measurement instrument that tries to Measure a characteristic or attitude that is believed to range across a Continue of values and cannot easily be directly measured.  The disabilities of the arm shoulder and hand (dash) symptom scale can Be used to evaluate a patient with a disorder of the upper extremity. it Can be used to monitor the patient over time and to determine the Effectiveness of an intervention.

The dash consists mainly o f a 3 0-item disability/symptom scale.

we Per formed cross cultural adaptation of the dash to swedish, using A process that included double forward and backward translations, Expert and lay review, as well as field -testing to achieve linguisti

And conceptual equivalence. the swedish Version reliability and validity were then evaluated.

REVIEW OF LITERATURE

HELEN H HOST (1995) Conducted a study to find out the effectiveness of scapular taping in the treatment of anterior shoulder impingement. The purpose of this case report is to describe how taping designed to promote proximal scapular stability was used in conjunction with other physical therapy interventions to manage a patient with anterior shoulder impingement. This case report demonstrates that a patient was able to return to all of his regular overhead sports activities without pain following scapular taping used in combination with a home exercise program. 

c. The term subacromial impingement was introduced by NEER, and refers to compression of rotator cuff, sub acromial bursa to biceps tendon against the anterior under surface of the acromian and coracoacromial ligament, especially during elevation of the arm.

VAN-DER WINDT (1995). The believe shoulder impingement are the most common cause of shoulder pain, and there is general consequences that impingement is the primary underlying problem or at least a migrating factor in many rotator cuff disorder. NEER estimated that 95% of rotator cuff tears are due to impingement.

 

AIMIE F. KACHINGWE et al (2008) Main outcome measures included 24-hour pain (VAS), pain with the Neer and Hawkins-Kennedy tests, shoulder active range of motion (AROM), and shoulder function (DASH). exercise program may result in a greater decrease in pain and improved function in patients with shoulder impingement .

MARK D THELEeN t al(2008) State that Self-reported pain and disability and pain-free active range of motion (ROM) were measured at multiple intervals to assess for differences between groups. Results showed that therapeutic kinesio tape showed immediate improvement in pain free shoulder abduction after tape application.

BOONSTRA et al (2008) such that Conducted a study to determine the reliability and concurrent validity of a visual analogue scale (VAS) for disability as a single-item instrument measurement. For the reliability study a test-retest design and for the validity study a cross-sectional design was used.

DESAI AS, DRAMIS A et al (2010) such that Conducted a study on critical appraisal of subjective outcome The DASH has shown to have good construct validity, excellent test-re-test reliability and responsiveness to change ome measures used in the assessment of shoulder disability. Five common shoulder patient-based scores were identified: disability of arm, shoulder and hand (DASH)

ALQUNAEE M et al (2012) Conducted a study to examine the accuracy of clinical tests for diagnosing subacromial impingement syndrome (SIS). They concluded that The Hawkins-Kennedy test, Neer's sign, and empty can test are shown to be more useful for ruling out rather than ruling in shoulder impingement syndrome.

DESANTIS, LUCY; HASSON, SCOTT (2006) Conducted a study of supraspinatus tendinopathy secondary to impingement. Outcome measures used included goniometric active range of motion (AROM) measurements and manual muscle tests of the shoulder, impingement tests, and the Shoulder Pain and Disability Index .This case report indicates that may be an effective treatment intervention for patients with subacromial impingement.

Dr. Kenzo Kase The method originated in Japan in 1973 and over the years it has stretched its horizons to many countries worldwide. History of Kinesio Taping Kinesio Taping is a modality treatment based on the body's own natural healing process.

ALQUNAEE M et al (2012) Conducted a study to examine the accuracy of clinical tests for diagnosing subacromial impingement syndrome . They concluded that The Hawkins-Kennedy test, Neer's sign, and empty can test are shown to be more useful for ruling out rather than ruling in shoulder impingement syndrome. GRAICHEN H, BONEL (1999)Suggesting that exercise in individuals with common postural deficits alter alters scapulohumeral rhythm.  

HARRYMAN H,BONEL (1990). Patient with impingement shows greater deficits alter Under loaded.

CELIK D, ET AL (2009) Did a study on comparison of the effects of two different Exercise programs on pain in subacromial impingment syndrome and concluded that the exercise program below 90 degrees (pain- free range of motion) resulted in additional improvement in vas scale.

JCLINNURSE,et al (2005) Did a study on pain : a review of pain rating scales and concluded that pain rating scale are valid, reliable and appropriate for use in clinical practice.

 KUHN F, et al(2000) Did a study on exercise in the treatment of rotator cuff impingement and concluded that the data demonstrate that exercise has statistically and clinically significant effects on pain reduction and improving function.

BONICA.JJ- VAS is quick and accurate scale by which paient rate heir pain.

MILLIS SR -2001 The vas is usefull as a screening measure to assist the clinician is quickly identifying problem in the doctor patient relationship. Patient who are unable to complete standard questionnaires also can use the VAS.

SKUTEK,M.R.W.FREMERECY.et al He concluded dash scale useful as a screening measure to assist the clinician in quickly identifying problems and early effectiveness achieved by using shoulder assessment scale.(DASH)

Thelen et al . ,(2008) Kinesio taping (KT) is becoming increasingly popular. Taping techniques aimed at improving circulation, pain, muscle activation, proprioception, and function.

Kase et al., (2003) KT is elastic and can be stretched Up to 55=60% of its length Allows unrestricted movement.

Stupik et al., (2007) Research is conflicting about whether or not kinesio taping can increase muscle activation.

Mac Gregor et al., (2005) Taping could stimulate cutaneous mechanoreceptors and Deliver more signals to the CNS.

Chen et al., (2008) Kinesio tape can lift the skin to increase space between skin And muscle, reducing the localized pressure, promoting Circulation and lymphatic drainage This theoretically reduces pain, swelling, and muscle spasm.

Halseth T (2004) KT can be applied to virtually any muscle or joint in the body. However, minimal evidence exists to support the use of this type of tape in the treatment of musculoskeletal disorders.

Green S (2003) Life time prevalence of shoulder pain has been reported to range from 7% to 36% of the population.   Matsen FA, Arntz CT (1990)Shoulder impingement has been defined as compression and mechanical abrasion of the rotator cuff structures as they pass beneath the coracoacromial arch during elevation of the arm

Whitney SL (1993) Multiple theories have been proposed to explain the primary etiology of shoulder impingement, including anatomic abnormalities of the coracoacromial arch or humeral head, “tension overload ,”ischemia, or degeneration of the rotator cuff tendons; and shoulder kinematic abnormalities   

Thank you