title: Pulsed electromagnetic field and exercises in patients with shoulder impingement syndrome: a randomized, double-blind, placebo-controlled clinical trial.
abstract: OBJECTIVE
  To evaluate the effects of pulsed electromagnetic field (PEMF) and exercises in reducing pain and improving function and muscle strength in patients with shoulder impingement syndrome (SIS).
  
  
  METHODS
  Double-blind, randomized controlled trial with a 3-month posttreatment follow-up.
  
  
  METHODS
  Outpatient rehabilitation of a public hospital.
  
  
  METHODS
  Patients (N=56) between 40 and 60 years of age, with a diagnosis of SIS, were randomly assigned to receive active PEMF (n=26; mean age, 50.1y) or placebo PEMF (n=30; mean age, 50.8y).
  
  
  METHODS
  After 3 weeks of active or placebo PEMF, both groups performed the same program of exercises that focused on shoulder strengthening.
  
  
  METHODS
  A visual analog scale, the University of California/Los Angeles shoulder rating scale, the Constant-Murley shoulder score, and handheld dynamometry for muscle strength were used as outcome measures at baseline (pretreatment), at 3 weeks (after active or placebo PEMF), at 9 weeks (postexercise), and at 3 months posttreatment.
  
  
  RESULTS
  Patients in the active PEMF group had a higher level of function and less pain at all follow-up time frames compared with baseline (P<.05). However, the placebo PEMF group had increased function and reduced pain only at the 9-week and 3-month follow-ups (P<.05)-that is, after performing the associated exercises. For the shoulder dynamometry, the active PEMF group had increased strength for lateral rotation at 9 weeks (P<.05), and increased strength for medial rotation at 9 weeks and 3 months (both P<.05) when compared with baseline. There was no significant difference for shoulder strength in the placebo PEMF group (P>.05), as well as no significant differences (P>.05) for all outcome measures.
  
  
  CONCLUSIONS
  The combination of PEMF and shoulder exercises is effective in improving function and muscle strength and decreasing pain in patients with SIS. However, these results should be carefully interpreted because of the lack of differences between groups.
authors.affiliation: Physical Therapy Sector, Irmandade da Santa Casa de Misericórdia, São Paulo, Brazil.
authors.forename: Diego
authors.initials: D
authors.lastname: Galace de Freitas
authors.affiliation: Physical Therapy Sector, Irmandade da Santa Casa de Misericórdia, São Paulo, Brazil.
authors.forename: Freddy Beretta
authors.initials: FB
authors.lastname: Marcondes
authors.affiliation: Physical Therapy Sector, Irmandade da Santa Casa de Misericórdia, São Paulo, Brazil.
authors.forename: Renan Lima
authors.initials: RL
authors.lastname: Monteiro
authors.affiliation: Physical Therapy Sector, Irmandade da Santa Casa de Misericórdia, São Paulo, Brazil.
authors.forename: Sabrina Gonçalves
authors.initials: SG
authors.lastname: Rosa
authors.affiliation: Orthopaedic and Traumatology Department, Irmandade da Santa Casa de Misericórdia, São Paulo, Brazil.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Maria de Moraes Barros Fucs
authors.affiliation: Physical Therapy Sector, Irmandade da Santa Casa de Misericórdia, São Paulo, Brazil. Electronic address: tfukuda10@yahoo.com.br.
authors.forename: Thiago Yukio
authors.initials: TY
authors.lastname: Fukuda
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003972:Diathermy; D004185:Disability Evaluation; D004311:Double-Blind Method; D004574:Electromagnetic Fields; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010919:Placebos; D016059:Range of Motion, Articular; D019534:Shoulder Impingement Syndrome / Q000534:rehabilitation*; D016896:Treatment Outcome
chemical_list: D010919:Placebos
keywords: Diathermy; ICC; MCID; Magnetic field therapy; PEMF; Rehabilitation; Rotator cuff; SIS; Shoulder impingement syndrome; UCLA; University of California/Los Angeles; VAS; intraclass correlation coefficient; minimal clinically important difference; pulsed electromagnetic field; shoulder impingement syndrome; visual analog scale