• L Pérez-Merino, M C Casajuana, G Bernal, J Faba, A E Astilleros, R González, M Giralt, M Romeu, and M R Nogués.
• Sant Joan University Hospital, Reus, Spain; Faculty of Medicine and Health Sciences, Rovira i Virgili University, Reus, Spain. Electronic address: laura.perez@urv.cat.
• Physiotherapy. 2016 Mar 1; 102 (1): 57-63.

ObjectiveTo determine whether dexketoprofen administered by phonophoresis or iontophoresis is more effective for the treatment of subacromial impingement syndrome (SIS) than conventional ultrasound therapy.DesignRandomised clinical trial.SettingUniversity hospital.ParticipantsNinety-nine participants with SIS without a complete tear of the rotator cuff were assigned at random to three intervention groups.Intervention GroupsParticipants received ultrasound (n=32), phonophoresis with dexketoprofen (50mg/session) (n=33) or iontophoresis with dexketoprofen (50mg/session) (n=34). All participants completed 20 treatment sessions plus exercise therapy and cryotherapy.Outcome MeasuresA visual analogue scale (VAS), the Constant-Murley Scale (CMS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were administered pre-treatment (baseline), post-treatment and 1 month post-treatment.ResultsAt baseline, there were no differences between the groups. Post-treatment, VAS score improved by -1.2 points and CMS score improved by 8.9 points in the ultrasound group compared with the iontophoresis group [95% confidence interval (CI) -0.2 to -2.2 and 95% CI 17.0 to 0.7, respectively]. CMS score improved by 7.1 points in the phonophoresis group compared with the iontophoresis group (95% CI 14.8 to -0.7). At 1 month post-treatment, no significant differences were detected between the groups. VAS, CMS and DASH scores of all groups improved post-treatment and at 1 month post-treatment.ConclusionUltrasound, iontophoresis with dexketoprofen and phonophoresis with dexketoprofen can improve pain, shoulder function, and physical functioning and symptoms in the upper limb in patients with SIS without a complete tear of the rotator cuff. CLINICAL TRIALS.Gov Registration NumberNCT01748188.Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

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