title: Efficiency of therapeutic ultrasound on pain, disability, anxiety, depression, sleep and quality of life in patients with subacromial impingement syndrome: A randomized controlled study.
abstract: Subacromial impingement syndrome (SIS) is characterized by pain and disability of shoulder. Various treatment methods have been used for SIS.
  
  
  
  The aim of our study was to evaluate efficacy of therapeutic ultrasound (US) on pain, disability, anxiety, depression, sleep quality and quality of life in patients with SIS.
  
  
  
  Patients with SIS were randomly divided into two groups, including the group 1 (continuous US group; 3 MHz, 1.5 W/cm2, n = 26) and group 2 (sham US group, n = 24). Additionally, transcutaneous electrical nerve stimulation (TENS) + exercise program were added in both groups. Pain and disability of the shoulder were assessed by the Shoulder Pain and Disability Index (SPADI), while anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Quality of life was evalutaed by the Nottingham Health Profile (NHP). Patients were evaluated at baseline and after end of three weeks.
  
  
  
  Both groups had significantly improvements in terms of SPADI-pain, SPADI-disability, SPADI-total, NHP-pain and NHP-sleep scores after the three weeks interventions. There were significantly improvements in the Group 1 in terms of PSQI-total, and NHP-physical activity. Group 2 had significantly improvements in terms of anxiety-HADS, depression-HADS and NHP-emotional reaction scores. In the inter-group comparison, there were no significantly differences in the change scores were observed in any domains of SPADI scores, anxiety, depression and sleep scores, or any NHP scores.
  
  
  
  Our study showed that US does not have any benefits on SIS. TENS + exercise program are not effective on anxiety, depression and fatigue, however TENS +$ exercise program are effective on pain, disability and sleep disturbance in patients with SIS.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Yazmalar
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Mustafa Akif
authors.initials: MA
authors.lastname: Sarıyıldız
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Batmaz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Yüzüncüyıl University, Van, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Alpaycı
authors.affiliation: Department of Physical Medicine and Rehabilitation, Memorial Hospital, Diyarbakır, Turkey.
authors.forename: Yahya Kemal
authors.initials: YK
authors.lastname: Burkan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dumlupınar University, Kütahya, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Özkan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Okçu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Remzi
authors.initials: R
authors.lastname: Çevik
mesh_terms: D000328:Adult; D001007:Anxiety / Q000628:therapy; D003863:Depression / Q000628:therapy; D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011788:Quality of Life; D019534:Shoulder Impingement Syndrome / Q000523:psychology / Q000628:therapy*; D020069:Shoulder Pain / Q000628:therapy; D012893:Sleep Wake Disorders / Q000628:therapy; D004561:Transcutaneous Electric Nerve Stimulation; D014464:Ultrasonic Therapy
keywords: Ultrasound; anxiety; depression; sleep; subacromial impingement