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ROTATOR CUFF YIRTIKLARINDA SOLUNUM EGZERSİZLERİNİN AĞRI VE FONKSİYONELLİK ÜZERİNE ETKİSİ: RANDOMİZE KONTROLLÜ ÇALIŞMA

Yıl 2025, Cilt: 6 Sayı: 1, 7 - 13, 28.04.2025

Burak Menek , Alper Ceylan , Umut İslam Tayboğa , Beyza Nur Erayata

https://doi.org/10.52831/kjhs.1573977

Öz

Amaç: Rotator cuff yırtıkları (RCY) omuzda ağrı, kuvvet kaybı ve fonksiyonel kısıtlılıklara neden olan yaygın yaralanmalar arasında yer almaktadır. Bu çalışmada RCY'de ağrıyı azaltmak ve fonksiyonel yetenekleri geliştirmek amacıyla solunum egzersizlerinin konvansiyonel fizyoterapiyle kombinasyonunun etkinliğinin incelenmesi amaçlandı.
Yöntem: Bu randomize ve tek kör çalışmada, 30-55 yaşları arasında RCY tanısı almış 30 birey yer aldı. Katılımcılar altı hafta boyunca rutin fizyoterapi uygulanan Konvansiyonel Grup (KG) ve aynı programa ek olarak solunum egzersizleri uygulanan Solunum Egzersizi Grubu’na (SEG) ayrıldı. Ağrı, Sayısal Ağrı Derecelendirme Ölçeği (NRS) ile ölçülürken; eklem hareket açıklığı (ROM) gonyometre ile, omuz fonksiyonelliği ise Kol, Omuz ve El Yetersizlik Anketi (DASH) ile değerlendirildi.
Bulgular: Tedavi öncesi gruplar arasında demografik özellikler ve temel ölçümler açısından anlamlı bir fark bulunmadı (p>0.05). Tedavi sonrasında her iki grupta da tüm parametrelerde iyileşme gözlendi (p<0.05). SEG, NRS-aktivite, DASH skoru ve Eklem Hareket Açıklığı (fleksiyon, abdüksiyon, internal ve eksternal rotasyon) açısından KG’ ye kıyasla istatistiksel olarak daha etkiliydi (p<0.05). Bununla birlikte, omuz ekstansiyonu hareket açıklığı açısından gruplar arasında istatistiksel olarak anlamlı bir fark saptanmadı; her iki grubun tedavi sonrası değerleri benzer düzeyde kaldı (p>0.05).
Sonuç: Solunum egzersizlerinin konvansiyonel fizyoterapiye eklenmesinin RCY tedavisinde ek faydalar sağladığı gözlendi. Bulgular, RCY tedavi protokollerine solunum egzersizlerinin dahil edilmesinin ağrı yönetimi ve fonksiyonel iyileşmeyi artırabileceğini gösterdi.

Anahtar Kelimeler

Solunum egzersizleri Fizyoterapi Rehabilitasyon Rotator cuff

Kaynakça

  • Luime J, Koes B, Hendriksen I, et al. Prevalence and incidence of shoulder pain in the general population: a systematic review. Scand J Rheumatol. 2004;33(2):73-81.
  • Osborne JD, Gowda AL, Wiater B, Wiater JM. Rotator cuff rehabilitation: current theories and practice. Phys Sportsmed. 2016;44(1):85-92.
  • Brindisino F, Salomon M, Giagio S, Pastore C, Innocenti T. Rotator cuff repair vs. nonoperative treatment: a systematic review with meta-analysis. J Shoulder Elbow Surg. 2021;30(11):2648-2659.
  • Yamamoto A, Takagishi K, Osawa T, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg. 2010;19(1):116-120.
  • Akbaba YA, Mutlu EK, Altun S, Turkmen E, Birinci T, Celik D. The effectiveness of trigger point treatment in rotator cuff pathology: a randomized controlled double-blind study. J Back Musculoskelet Rehabil. 2019;32(3):519-527.
  • Zhao Q, Palani P, Kassab NS, et al. Evidence-based approach to the shoulder examination for subacromial bursitis and rotator cuff tears: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2024;25(1):1028.
  • Longo UG, Risi Ambrogioni L, Candela V, et al. Conservative versus surgical management for patients with rotator cuff tears: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2021;22(1):50.
  • Moosmayer S, Lund G, Seljom U, et al. Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff: a randomised controlled study of 103 patients with one-year follow-up. J Bone Joint Surg Br. 2010;92-B(1):83-91.
  • Menek B, Tarakci D, Algun ZC. The effect of Mulligan mobilization on pain and life quality of patients with rotator cuff syndrome: a randomized controlled trial. J Back Musculoskelet Rehabil. 2019;32(1):171-178.
  • Wang S, Zeng J, Mani R, Chapple CM, Ribeiro DC. The immediate effects of mobilization with movement on shoulder range of motion and pain in patients with rotator cuff-related shoulder pain: a randomized controlled trial (Evolution Trial). Braz J Phys Ther. 2024;28(6):101145.
  • Lee BK. Effects of the combined PNF and deep breathing exercises on the ROM and the VAS score of a frozen shoulder patient: single case study. J Exerc Rehabil. 2015;11(5):276-281.
  • Jafari H, Gholamrezaei A, Franssen M, et al. Can slow deep breathing reduce pain? An experimental study exploring mechanisms. J Pain. 2020;21(9-10):1018-1030.
  • Anderson BE, Bliven KCH. The use of breathing exercises in the treatment of chronic, nonspecific low back pain. J Sport Rehabil. 2017;26(5):452-458.
  • Zwaag J, Naaktgeboren R, van Herwaarden AE, et al. The effects of cold exposure training and a breathing exercise on the inflammatory response in humans: a pilot study. Psychosom Med. 2022;84(4):457-467.
  • Sundstrup E, Andersen LL. Hard physical work intensifies the occupational consequence of physician-diagnosed back disorder: prospective cohort study with register follow-up among 10,000 workers. Int J Rheumatol. 2017;2017:1037051.
  • Sharma S, Bhardwaj S, Gupta A, et al. Influence of 24-week yoga intervention on cardiovascular risk factors and inflammatory markers in type 2 diabetes. Int J Yoga. 2023;16(1):27-33.
  • Lopes CP, Danzmann LC, Moraes RS, et al. Yoga and breathing technique training in patients with heart failure and preserved ejection fraction: study protocol for a randomized clinical trial. Trials. 2018;19(1):405.
  • Rashed SS, Okeel FM, Yousef AM, et al. Effect of adding diaphragmatic breathing to corrective exercises on kyphotic angle and diaphragmatic excursion in postmenopausal kyphotic women: a randomized controlled trial. Physiother Res Int. 2024;29(3):e2100.
  • Fernández-López I, Peña-Otero D, de los Ángeles Atín-Arratibel M, et al. Effects of diaphragm muscle treatment in shoulder pain and mobility in subjects with rotator cuff injuries: a dataset derived from a pilot clinical trial. Data Brief. 2021;35:106867.
  • Yokogawa M, Kurebayashi T, Ichimura T, et al. Comparison of two instructions for deep breathing exercise: non-specific and diaphragmatic breathing. J Phys Ther Sci. 2018;30(4):614-618.
  • Azab AR, Abdelbasset WK, Alrawaili SM, et al. Effect of chest resistance and expansion exercises on respiratory muscle strength, lung function, and thoracic excursion in children with a post-operative congenital diaphragmatic hernia. Int J Environ Res Public Health. 2022;19(10):6101.
  • Griffin RS, Antoniak M, Mac PD, et al. Imagined examples of painful experiences provided by chronic low back pain patients and attributed a pain numerical rating score. Front Neurosci. 2020;13:1331.
  • Naylor JC, Kilts JD, Shampine LJ, et al. Effect of pregnenolone vs placebo on self-reported chronic low back pain among US military veterans: a randomized clinical trial. JAMA Netw Open. 2020;3(3):e200287.
  • Menek B, Tarakci D, Tarakci E, et al. Investigation on the efficiency of the closed kinetic chain and video-based game exercise programs in the rotator cuff rupture: a randomized trial. Games Health J. 2022;11(5):298-306.
  • Hudak PL, Amadio PC, Bombardier C, et al. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder, and head). Am J Ind Med. 1996;29(6):602-608.
  • Rezaie M, Negahban H, Mostafaee N, et al. Comparison of the physiotherapy with and without focus on the scapulothoracic joint on pain, range of motion, functional disability, quality of life, and treatment effectiveness of patients after arthroscopic shoulder rotator cuff tendon repair: a randomized controlled trial with short-term follow-up. J Hand Ther. 2024;37(3):319-330.
  • Cohen J. Statistical power analysis for the behavioral sciences. 2th ed. New York: Routledge; 2013.
  • Dejaco B, Habets B, van Loon C, et al. Eccentric versus conventional exercise therapy in patients with rotator cuff tendinopathy: a randomized, single blinded, clinical trial. Knee Surg Sports Traumatol Arthrosc. 2017;25(7):2051-2059.
  • Ryösä A, Laimi K, Äärimaa V, et al. Surgery or conservative treatment for rotator cuff tear: a meta-analysis. Disabil Rehabil. 2017;39(14):1357-1363.
  • Kukkonen J, Joukainen A, Lehtinen J, et al. Treatment of non-traumatic rotator cuff tears: a randomised controlled trial with one-year clinical results. Bone Joint J. 2014;96-B(1):75-81.
  • Heerspink FOL, van Raay JJ, Koorevaar RC, et al. Comparing surgical repair with conservative treatment for degenerative rotator cuff tears: a randomized controlled trial. J Shoulder Elbow Surg. 2015;24(8):1274-1281.
  • Tiryaki P, Çelik D, Bilsel K, et al. Effectiveness of exercises with electromyographic biofeedback in conservative treatment of massive rotator cuff tears: a randomized controlled study. Am J Phys Med Rehabil. 2023;102(5):419-426.
  • Kjær BH, Magnusson SP, Henriksen M, et al. Effects of 12 weeks of progressive early active exercise therapy after surgical rotator cuff repair: 12 weeks and 1-year results from the CUT-N-MOVE randomized controlled trial. Am J Sports Med. 2021;49(2):321-331.
  • Özdemir M, Yaşar MF, Yakşi E. Effect of pulsed electromagnetic field therapy in patients with supraspinatus tendon tear. Rev Assoc Med Bras. 2021;67(2):282-286.
  • Busch V, Magerl W, Kern U, et al. The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing: an experimental study. Pain Med. 2012;13(2):215-228.
  • Bastamizad N, Abbasi P, Salari N, et al. Comparing the effect of incentive spirometry and deep breathing exercises on the level of shoulder pain and nausea following laparoscopic cholecystectomy surgery: a clinical trial study. Gastroenterol Nurs. 2023;46(1):14-22.
  • Fernández-López I, Peña-Otero D, Eguillor-Mutiloa M, et al. Manual therapy on the diaphragm is beneficial in reducing pain and improving shoulder mobility in subjects with rotator cuff injury: a randomized trial. Int J Osteopath Med. 2023;50:100682.
  • Fernández-Lopez I, Peña-Otero D, de los Ángeles Atín-Arratibel M, et al. Effects of manual therapy on the diaphragm in the musculoskeletal system: a systematic review. Arch Phys Med Rehabil. 2021;102(12):2402-2415.
  • Tatsios P, Koumantakis GA, Karakasidou P, et al. The effectiveness of manual therapy on musculoskeletal and respiratory parameters in patients with chronic low back pain: a systematic review. Crit Rev Phys Rehabil Med. 2021;33(2):1-17.
  • McLaughlin L. Breathing evaluation and retraining in manual therapy. J Bodyw Mov Ther. 2009;13(3):276-282.

EFFECTS OF BREATHING EXERCISES ON PAIN AND FUNCTIONALITY IN ROTATOR CUFF TEARS: A RANDOMIZED CONTROLLED TRIAL

Yıl 2025, Cilt: 6 Sayı: 1, 7 - 13, 28.04.2025

Burak Menek , Alper Ceylan , Umut İslam Tayboğa , Beyza Nur Erayata

https://doi.org/10.52831/kjhs.1573977

Öz

Objective: Rotator cuff tears (RCT) were common shoulder injuries that caused pain, strength loss, and functional impairment. This study assessed the effectiveness of adding breathing exercises to conventional physiotherapy to alleviate pain and improve functionality in individuals with RCT.
Method: In this single-blind, randomized controlled trial, 30 participants aged 30–55 with diagnosed RCT were allocated into two groups: the Conventional Group (CG), receiving standard physiotherapy, and the Breathing Exercise Group (BEG), receiving standard physiotherapy plus breathing exercises for six weeks. Outcome measures included pain intensity assessed by the Numeric Pain Rating Scale (NRS), range of motion (ROM) measured with a goniometer, and shoulder functionality evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.
Results: Baseline demographic and clinical parameters did not differ significantly between groups (p>0.05). Both groups demonstrated significant improvements in pain, ROM, and DASH scores post-treatment (p<0.05). However, BEG showed superior improvements in nearly all outcomes, with statistically significant differences in NRS-activity, DASH scores, and ROM (flexion, abduction, internal and external rotation) compared to CG (p<0.05). No significant difference was observed in shoulder extension ROM between the groups.
Conclusion: The integration of breathing exercises into conventional physiotherapy significantly enhances pain relief and functional outcomes in individuals with RCT. These findings support the inclusion of breathing exercises as a complementary approach in conservative rehabilitation programs for rotator cuff injuries.

Anahtar Kelimeler

Breathing exercises Physiotherapy Rehabilitation Rotator cuff

Kaynakça

  • Luime J, Koes B, Hendriksen I, et al. Prevalence and incidence of shoulder pain in the general population: a systematic review. Scand J Rheumatol. 2004;33(2):73-81.
  • Osborne JD, Gowda AL, Wiater B, Wiater JM. Rotator cuff rehabilitation: current theories and practice. Phys Sportsmed. 2016;44(1):85-92.
  • Brindisino F, Salomon M, Giagio S, Pastore C, Innocenti T. Rotator cuff repair vs. nonoperative treatment: a systematic review with meta-analysis. J Shoulder Elbow Surg. 2021;30(11):2648-2659.
  • Yamamoto A, Takagishi K, Osawa T, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg. 2010;19(1):116-120.
  • Akbaba YA, Mutlu EK, Altun S, Turkmen E, Birinci T, Celik D. The effectiveness of trigger point treatment in rotator cuff pathology: a randomized controlled double-blind study. J Back Musculoskelet Rehabil. 2019;32(3):519-527.
  • Zhao Q, Palani P, Kassab NS, et al. Evidence-based approach to the shoulder examination for subacromial bursitis and rotator cuff tears: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2024;25(1):1028.
  • Longo UG, Risi Ambrogioni L, Candela V, et al. Conservative versus surgical management for patients with rotator cuff tears: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2021;22(1):50.
  • Moosmayer S, Lund G, Seljom U, et al. Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff: a randomised controlled study of 103 patients with one-year follow-up. J Bone Joint Surg Br. 2010;92-B(1):83-91.
  • Menek B, Tarakci D, Algun ZC. The effect of Mulligan mobilization on pain and life quality of patients with rotator cuff syndrome: a randomized controlled trial. J Back Musculoskelet Rehabil. 2019;32(1):171-178.
  • Wang S, Zeng J, Mani R, Chapple CM, Ribeiro DC. The immediate effects of mobilization with movement on shoulder range of motion and pain in patients with rotator cuff-related shoulder pain: a randomized controlled trial (Evolution Trial). Braz J Phys Ther. 2024;28(6):101145.
  • Lee BK. Effects of the combined PNF and deep breathing exercises on the ROM and the VAS score of a frozen shoulder patient: single case study. J Exerc Rehabil. 2015;11(5):276-281.
  • Jafari H, Gholamrezaei A, Franssen M, et al. Can slow deep breathing reduce pain? An experimental study exploring mechanisms. J Pain. 2020;21(9-10):1018-1030.
  • Anderson BE, Bliven KCH. The use of breathing exercises in the treatment of chronic, nonspecific low back pain. J Sport Rehabil. 2017;26(5):452-458.
  • Zwaag J, Naaktgeboren R, van Herwaarden AE, et al. The effects of cold exposure training and a breathing exercise on the inflammatory response in humans: a pilot study. Psychosom Med. 2022;84(4):457-467.
  • Sundstrup E, Andersen LL. Hard physical work intensifies the occupational consequence of physician-diagnosed back disorder: prospective cohort study with register follow-up among 10,000 workers. Int J Rheumatol. 2017;2017:1037051.
  • Sharma S, Bhardwaj S, Gupta A, et al. Influence of 24-week yoga intervention on cardiovascular risk factors and inflammatory markers in type 2 diabetes. Int J Yoga. 2023;16(1):27-33.
  • Lopes CP, Danzmann LC, Moraes RS, et al. Yoga and breathing technique training in patients with heart failure and preserved ejection fraction: study protocol for a randomized clinical trial. Trials. 2018;19(1):405.
  • Rashed SS, Okeel FM, Yousef AM, et al. Effect of adding diaphragmatic breathing to corrective exercises on kyphotic angle and diaphragmatic excursion in postmenopausal kyphotic women: a randomized controlled trial. Physiother Res Int. 2024;29(3):e2100.
  • Fernández-López I, Peña-Otero D, de los Ángeles Atín-Arratibel M, et al. Effects of diaphragm muscle treatment in shoulder pain and mobility in subjects with rotator cuff injuries: a dataset derived from a pilot clinical trial. Data Brief. 2021;35:106867.
  • Yokogawa M, Kurebayashi T, Ichimura T, et al. Comparison of two instructions for deep breathing exercise: non-specific and diaphragmatic breathing. J Phys Ther Sci. 2018;30(4):614-618.
  • Azab AR, Abdelbasset WK, Alrawaili SM, et al. Effect of chest resistance and expansion exercises on respiratory muscle strength, lung function, and thoracic excursion in children with a post-operative congenital diaphragmatic hernia. Int J Environ Res Public Health. 2022;19(10):6101.
  • Griffin RS, Antoniak M, Mac PD, et al. Imagined examples of painful experiences provided by chronic low back pain patients and attributed a pain numerical rating score. Front Neurosci. 2020;13:1331.
  • Naylor JC, Kilts JD, Shampine LJ, et al. Effect of pregnenolone vs placebo on self-reported chronic low back pain among US military veterans: a randomized clinical trial. JAMA Netw Open. 2020;3(3):e200287.
  • Menek B, Tarakci D, Tarakci E, et al. Investigation on the efficiency of the closed kinetic chain and video-based game exercise programs in the rotator cuff rupture: a randomized trial. Games Health J. 2022;11(5):298-306.
  • Hudak PL, Amadio PC, Bombardier C, et al. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder, and head). Am J Ind Med. 1996;29(6):602-608.
  • Rezaie M, Negahban H, Mostafaee N, et al. Comparison of the physiotherapy with and without focus on the scapulothoracic joint on pain, range of motion, functional disability, quality of life, and treatment effectiveness of patients after arthroscopic shoulder rotator cuff tendon repair: a randomized controlled trial with short-term follow-up. J Hand Ther. 2024;37(3):319-330.
  • Cohen J. Statistical power analysis for the behavioral sciences. 2th ed. New York: Routledge; 2013.
  • Dejaco B, Habets B, van Loon C, et al. Eccentric versus conventional exercise therapy in patients with rotator cuff tendinopathy: a randomized, single blinded, clinical trial. Knee Surg Sports Traumatol Arthrosc. 2017;25(7):2051-2059.
  • Ryösä A, Laimi K, Äärimaa V, et al. Surgery or conservative treatment for rotator cuff tear: a meta-analysis. Disabil Rehabil. 2017;39(14):1357-1363.
  • Kukkonen J, Joukainen A, Lehtinen J, et al. Treatment of non-traumatic rotator cuff tears: a randomised controlled trial with one-year clinical results. Bone Joint J. 2014;96-B(1):75-81.
  • Heerspink FOL, van Raay JJ, Koorevaar RC, et al. Comparing surgical repair with conservative treatment for degenerative rotator cuff tears: a randomized controlled trial. J Shoulder Elbow Surg. 2015;24(8):1274-1281.
  • Tiryaki P, Çelik D, Bilsel K, et al. Effectiveness of exercises with electromyographic biofeedback in conservative treatment of massive rotator cuff tears: a randomized controlled study. Am J Phys Med Rehabil. 2023;102(5):419-426.
  • Kjær BH, Magnusson SP, Henriksen M, et al. Effects of 12 weeks of progressive early active exercise therapy after surgical rotator cuff repair: 12 weeks and 1-year results from the CUT-N-MOVE randomized controlled trial. Am J Sports Med. 2021;49(2):321-331.
  • Özdemir M, Yaşar MF, Yakşi E. Effect of pulsed electromagnetic field therapy in patients with supraspinatus tendon tear. Rev Assoc Med Bras. 2021;67(2):282-286.
  • Busch V, Magerl W, Kern U, et al. The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing: an experimental study. Pain Med. 2012;13(2):215-228.
  • Bastamizad N, Abbasi P, Salari N, et al. Comparing the effect of incentive spirometry and deep breathing exercises on the level of shoulder pain and nausea following laparoscopic cholecystectomy surgery: a clinical trial study. Gastroenterol Nurs. 2023;46(1):14-22.
  • Fernández-López I, Peña-Otero D, Eguillor-Mutiloa M, et al. Manual therapy on the diaphragm is beneficial in reducing pain and improving shoulder mobility in subjects with rotator cuff injury: a randomized trial. Int J Osteopath Med. 2023;50:100682.
  • Fernández-Lopez I, Peña-Otero D, de los Ángeles Atín-Arratibel M, et al. Effects of manual therapy on the diaphragm in the musculoskeletal system: a systematic review. Arch Phys Med Rehabil. 2021;102(12):2402-2415.
  • Tatsios P, Koumantakis GA, Karakasidou P, et al. The effectiveness of manual therapy on musculoskeletal and respiratory parameters in patients with chronic low back pain: a systematic review. Crit Rev Phys Rehabil Med. 2021;33(2):1-17.
  • McLaughlin L. Breathing evaluation and retraining in manual therapy. J Bodyw Mov Ther. 2009;13(3):276-282.
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Fizyoterapi, Rehabilitasyon
Bölüm Araştırma Makaleleri
Yazarlar

Burak Menek 0000-0002-5206-0254

Alper Ceylan 0000-0001-9868-9413

Umut İslam Tayboğa 0000-0003-2575-045X

Beyza Nur Erayata 0009-0000-8316-5932

Yayımlanma Tarihi 28 Nisan 2025
Gönderilme Tarihi 27 Ekim 2024
Kabul Tarihi 14 Ocak 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 6 Sayı: 1

Kaynak Göster

Vancouver Menek B, Ceylan A, Tayboğa Uİ, Erayata BN. EFFECTS OF BREATHING EXERCISES ON PAIN AND FUNCTIONALITY IN ROTATOR CUFF TEARS: A RANDOMIZED CONTROLLED TRIAL. Karya J Health Sci. 2025;6(1):7-13.
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