Water-Based versus Land-Based Exercise Program for the Management of Shoulder Impingement Syndrome

Objective: In this study, we aimed to compare the clinical effect of land-based and water-based exercise programs in patients with subacromial impingement syndrome. Materials and Methods: Seventy shoulders were randomized to water-based (n=35) or land-based (n=35) exercise program. The intervention in the water-based exercise group consisted of hot pack, transcutaneous electrical nerve stimulation (TENS), ultrasound (US) and exercise in the water; and in the land-based exercise group, consisted of hot pack, TENS, US and land-based exercises. The measurement was performed after the treatment and 3 months after the beginning of the treatment. We used visual analog scale (VAS) for pain assessment and shoulder function was measured with the Shoulder Pain and Disability Index and the Western Ontario Rotator Cuff Index. Results: Patient demographics and baseline values were similar for both groups. The pain reduction in both groups was statistically significant at the first follow-up. A significant reduction in pain at second follow-up was observed in the water-based exercise group compared with the land-based exercise group. We found statistically significant recuperation in both groups for functional index and more recuperation in the water-based exercise group at the second follow-up. Conclusion: A greater improvement in pain and functional capacity was achieved with combination of physical therapy and water-based exercise program in patients with subacromial impingement syndrome. Turk J Phys Med Re-hab 2012;58:79-84.