title: Comparative effectiveness of ultrasonophoresis and iontophoresis in impingement syndrome: a double-blind, randomized, placebo controlled trial.
abstract: OBJECTIVE
  To estimate the effectiveness of ultrasonophoresis and iontophoresis with sodium diclofenac used in addition to an exercise program for patients with impingement syndrome.
  
  
  METHODS
  Multicentre, double-blind, placebo randomized controlled trial.
  
  
  METHODS
  "Mancha Centro" Outpatient primary care clinic (Spain).
  
  
  METHODS
  A total of 175 patients were considered, of whom 88 met criteria and agreed.
  
  
  METHODS
  The patients were randomly assigned to one of three groups: a) standard treatment (supervised exercises and cryotherapy) along with placebo iontophoresis and placebo ultrasonophoresis; b) standard treatment, iontophoresis, and placebo ultrasonophoresis; and c) standard treatment, ultrasonophoresis, and placebo iontophoresis. All patients received 15 treatment sessions.
  
  
  METHODS
  Baseline, 6-, and 12-week evaluations were carried out. Functionality, pain, range of motion, strength and quality of life were assessed with the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), Constant-Murley score, and SF-36 scale.
  
  
  RESULTS
  Ultrasonophoresis group experienced significant decreases in pain compared to the standard treatment group (12.7 and 13.5 points in "bodily pain" dimension of SF-36; and 1,5 and 2,2 points in "pain" dimension of Constant Murley after 6 and 12 weeks of therapy, respectively). They also reported improved range of motion compared to the exercises group (2,1 points in Constant-Murley after 6 weeks and 12 weeks), better vitality and overall health (SF-36 dimensions). Iontophoresis, however, led to no significant improvements when added to the standard treatment.
  
  
  CONCLUSIONS
  In patients with impingement syndrome, a combination of ultrasonophoresis and an exercise program are better than a combination of iontophoresis and the same exercise program or the exercise program alone.
authors: Healthcare Centre Tomelloso I and Healthcare centre Madridejos (La Mancha Centro), Spain is_gm@hotmail.com.
authors: Isabel
authors: I
authors: García
authors: Healthcare Centre Argamasilla de Alba (La Mancha Centro), Spain.
authors: Cristina
authors: C
authors: Lobo
authors: Healthcare Centre Alcázar II (La Mancha Centro), Spain.
authors: Esther
authors: E
authors: López
authors: Healthcare Centre Alcázar II (La Mancha Centro), Spain.
authors: Jose Luis
authors: JL
authors: Serván
authors: Research Support Unit (La Mancha Centro), Spain.
authors: Jose María
authors: JM
authors: Tenías
mesh_terms: D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007478:Iontophoresis; D008297:Male; D008875:Middle Aged; D000070636:Rotator Cuff Injuries / Q000628:therapy*; D019534:Shoulder Impingement Syndrome / Q000628:therapy*; D014465:Ultrasonics
keywords: Impingement syndrome; iontophoresis; phonophoresis; shoulder pain; ultrasonophoresis