Investigation of the Effectiveness of Core Stabilization Training in Patients With Subacromial Impingement Syndrome

Investigation of The Efficacy of Core Stabilization Training in Patients With Subacromial Impingement Syndrome: A Randomized Controlled Study

Subacromial Impingement Syndrome (SIS) is one of the most common shoulder problems. The core region is considered a kinetic link that facilitates the transfer of torque and angular momentum between the upper and lower extremities during body movements. The decrease in core stabilization affects both trunk control and the quality of extremity movements depending on the kinetic chain in the body. The improvement in core stabilization balances the load transfer between the trunk and the extremities and reduces the asymmetry between the extremities. Core stabilization training should be included in rehabilitation programs as core stabilization is adversely affected in patients with SIS. For this reason, this study was planned to examine the effects of core stabilization training applied in addition to conventional treatment in patients with SIS on pain, range of motion, shoulder muscles strenght and core stability.

Study Overview

• Status: Completed
• Conditions: Subacromial Impingement Syndrome
• Intervention / Treatment: Other: Core stabilization training; Other: Standart Rehabilitation

• Study Type: Interventional
• Enrollment (Actual): 44
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Balıkesir
    • Bandırma, Balıkesir, Turkey (Türkiye), 10200
      • Eren Özen

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Being diagnosed with subacromial impingement syndrome,
• Being between the ages of 18-65,
• Not having received medical treatment,
• Not having received a shoulder-related physiotherapy program in the last 1 year,
• Not having undergone any shoulder-related surgery,
• Being able to read and understand Turkish

Exclusion Criteria:

• Neurological deficits of the upper extremity and the presence of another orthopedic disease, rheumatic and congenital disease other than CNS
• Presence of mental problems,
• To have received corticosteroid treatment in the last year,
• Having cardiovascular and systemic diseases that prevent work,
• Pregnancy,
• Those with communication problems

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Core stabilization group; Individuals included in this group will receive 20 minutes of core stabilization training in addition to 40 minutes of standard rehabilitation. Patients will be trained 5 days a week for first 3 weeks(standart rehabilitation + core stabilization training) then will be trained 3 days a week on 4-6 week (only core stabilization training). The next 6 weeks will be given a home exercise program including shoulder exercises and core stabilization training.	Other: Core stabilization training; First, while focusing on the activation methods of deep cervical flexor, transversus abdominus and multifidus muscles in individuals; In the next stages, exercises will be performed that will preserve the contraction of the deep cervical flexor, transversus abdominus and multifidus muscles and activate the other muscles of the body.; Other: Standart Rehabilitation; This treatment includes shoulder exercises and conventional therapy (Infrared, TENS).
Other: Control group; Individuals included in this group will receive only 40 minutes of standard rehabilitation. Patients will be trained 5 days a week for first 3 weeks(only standart rehabilitation). The next 9 weeks will be given a home exercise program including shoulder exercises.	Other: Standart Rehabilitation; This treatment includes shoulder exercises and conventional therapy (Infrared, TENS).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analogue Scale	It is used to assess the severity of pain. Pain severity with Visual Analogue Scale,(0-10) higher scores indicate more pain.	Baseline
Visual Analogue Scale	It is used to assess the severity of pain. Pain severity with Visual Analogue Scale,(0-10)higher scores indicate more pain.	3 week
Visual Analogue Scale	It is used to assess the severity of pain. Pain severity with Visual Analogue Scale,(0-10)higher scores indicate more pain.	6 week
Visual Analogue Scale	It is used to assess the severity of pain. Pain severity with Visual Analogue Scale,(0-10)higher scores indicate more pain.	12 week
Digital dynamometer	It will be used to measure the strength of the shoulder muscles.	Baseline
Digital dynamometer	It will be used to measure the strength of the shoulder muscles.	3 week
Digital dynamometer	It will be used to measure the strength of the shoulder muscles.	6 week
Digital dynamometer	It will be used to measure the strength of the shoulder muscles.	12 week
QuickDASH	It is a questionnaire that evaluates disorders in all upper extremity functions. The QuickDASH is an abbreviated 11-question subset from the original Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. The questionnaire's answers are scored on a 1-5 points scale that is then transformed to result in a score that ranges from 0 (indicating least disability) to 100 (indicating most disability).	Baseline
QuickDASH	It is a questionnaire that evaluates disorders in all upper extremity functions. The QuickDASH is an abbreviated 11-question subset from the original Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. The questionnaire's answers are scored on a 1-5 points scale that is then transformed to result in a score that ranges from 0 (indicating least disability) to 100 (indicating most disability).	3 week
QuickDASH	It is a questionnaire that evaluates disorders in all upper extremity functions. The QuickDASH is an abbreviated 11-question subset from the original Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. The questionnaire's answers are scored on a 1-5 points scale that is then transformed to result in a score that ranges from 0 (indicating least disability) to 100 (indicating most disability).	6 week
QuickDASH	It is a questionnaire that evaluates disorders in all upper extremity functions.The QuickDASH is an abbreviated 11-question subset from the original Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. The questionnaire's answers are scored on a 1-5 points scale that is then transformed to result in a score that ranges from 0 (indicating least disability) to 100 (indicating most disability).	12 week
Modified "Biering-Sorensen" test	Test will be applied to assess the endurance of the core muscles. The subjects are positioned in the prone position. The subjects are asked to extend their upper body straight forward from the edge of the table. How long the patient was able to perform the test was recorded in seconds.	Baseline
Modified "Biering-Sorensen" test	Test will be applied to assess the endurance of the core muscles. The subjects are positioned in the prone position. The subjects are asked to extend their upper body straight forward from the edge of the table. How long the patient was able to perform the test was recorded in seconds.	3 week
Modified "Biering-Sorensen" test	Test will be applied to assess the endurance of the core muscles. The subjects are positioned in the prone position. The subjects are asked to extend their upper body straight forward from the edge of the table. How long the patient was able to perform the test was recorded in seconds.	6 week
Modified "Biering-Sorensen" test	Test will be applied to assess the endurance of the core muscles. The subjects are positioned in the prone position. The subjects are asked to extend their upper body straight forward from the edge of the table. How long the patient was able to perform the test was recorded in seconds.	12 week
Trunk flexors endurance test	Test will be applied to assess the endurance of the core muscles. Participants will be positioned with trunk flexed to 60º, knees and hips to 90º flexion. The evaluator fixes the feet on the ground by supporting them from the toes. When the 60º trunk flexion is broken, the test will be terminated. How long the patient was able to perform the test was recorded in seconds.	Baseline
Trunk flexors endurance test	Test will be applied to assess the endurance of the core muscles. Participants will be positioned with trunk flexed to 60º, knees and hips to 90º flexion. The evaluator fixes the feet on the ground by supporting them from the toes. When the 60º trunk flexion is broken, the test will be terminated. How long the patient was able to perform the test was recorded in seconds.	3 week
Trunk flexors endurance test	Test will be applied to assess the endurance of the core muscles. Participants will be positioned with trunk flexed to 60º, knees and hips to 90º flexion. The evaluator fixes the feet on the ground by supporting them from the toes. When the 60º trunk flexion is broken, the test will be terminated. How long the patient was able to perform the test was recorded in seconds.	6 week
Trunk flexors endurance test	Test will be applied to assess the endurance of the core muscles. Participants will be positioned with trunk flexed to 60º, knees and hips to 90º flexion. The evaluator fixes the feet on the ground by supporting them from the toes. When the 60º trunk flexion is broken, the test will be terminated. How long the patient was able to perform the test was recorded in seconds.	12 week
Lateral bridge test	Test will be applied to assess the endurance of the core muscles. The subjects were asked to lie on their side, raise their bodies on their forearms and toes and maintain this position(both sides). How long the patient was able to perform the test was recorded in seconds.	Baseline
Lateral bridge test	Test will be applied to assess the endurance of the core muscles. The subjects were asked to lie on their side, raise their bodies on their forearms and toes and maintain this position(both sides). How long the patient was able to perform the test was recorded in seconds.	3 week
Lateral bridge test	Test will be applied to assess the endurance of the core muscles. The subjects were asked to lie on their side, raise their bodies on their forearms and toes and maintain this position(both sides). How long the patient was able to perform the test was recorded in seconds.	6 week
Lateral bridge test	Test will be applied to assess the endurance of the core muscles. The subjects were asked to lie on their side, raise their bodies on their forearms and toes and maintain this position(both sides). How long the patient was able to perform the test was recorded in seconds.	12 week
Prone bridge test	Test will be applied to assess the endurance of the core muscles. The subjects put their elbows on the ground as the starting position and open their feet about the width of their hips while keeping their body straight. The tests end when the subjects break the test positions. How long the patient was able to perform the test was recorded in seconds.	Baseline
Prone bridge test	Test will be applied to assess the endurance of the core muscles. The subjects put their elbows on the ground as the starting position and open their feet about the width of their hips while keeping their body straight. The tests end when the subjects break the test positions. How long the patient was able to perform the test was recorded in seconds.	3 week
Prone bridge test	Test will be applied to assess the endurance of the core muscles. The subjects put their elbows on the ground as the starting position and open their feet about the width of their hips while keeping their body straight. The tests end when the subjects break the test positions. How long the patient was able to perform the test was recorded in seconds.	6 week
Prone bridge test	Test will be applied to assess the endurance of the core muscles. The subjects put their elbows on the ground as the starting position and open their feet about the width of their hips while keeping their body straight. The tests end when the subjects break the test positions. How long the patient was able to perform the test was recorded in seconds.	12 week
Modified "Push-ups" test	Test will be applied to assess the strength of the core muscles. The subjects are positioned in the prone position with their hands shoulder-width apart and elbows and knees flexed. The subjects were asked to raise their body up by extending their elbows. The number of times the patient repeats the movement in 30 seconds is recorded.	Baseline
Modified "Push-ups" test	Test will be applied to assess the strength of the core muscles. The subjects are positioned in the prone position with their hands shoulder-width apart and elbows and knees flexed. The subjects were asked to raise their body up by extending their elbows. The number of times the patient repeats the movement in 30 seconds is recorded.	3 week
Modified "Push-ups" test	Test will be applied to assess the strength of the core muscles. The subjects are positioned in the prone position with their hands shoulder-width apart and elbows and knees flexed. The subjects were asked to raise their body up by extending their elbows. The number of times the patient repeats the movement in 30 seconds is recorded.	6 week
Modified "Push-ups" test	Test will be applied to assess the strength of the core muscles. The subjects are positioned in the prone position with their hands shoulder-width apart and elbows and knees flexed. The subjects were asked to raise their body up by extending their elbows. The number of times the patient repeats the movement in 30 seconds is recorded.	12 week
Sit-ups test	Test will be applied to assess the strength of the core muscles. The subjects are asked to flex the trunk while the knees are flexed in the supine position. During the test, the feet of subjects are stabilized. The number of times the patient repeats the movement in 30 seconds is recorded.	Baseline
Sit-ups test	Test will be applied to assess the strength of the core muscles. The subjects are asked to flex the trunk while the knees are flexed in the supine position. During the test, the feet of subjects are stabilized. The number of times the patient repeats the movement in 30 seconds is recorded.	3 week
Sit-ups test	Test will be applied to assess the strength of the core muscles. The subjects are asked to flex the trunk while the knees are flexed in the supine position. During the test, the feet of subjects are stabilized. The number of times the patient repeats the movement in 30 seconds is recorded.	6 week
Sit-ups test	Test will be applied to assess the strength of the core muscles. The subjects are asked to flex the trunk while the knees are flexed in the supine position. During the test, the feet of subjects are stabilized. The number of times the patient repeats the movement in 30 seconds is recorded.	12 week
Stabilizer pressure biofeedback device	This device will be used to measure deep cervical flexor muscles endurance.	Baseline
Stabilizer pressure biofeedback device	This device will be used to measure deep cervical flexor muscles endurance.	3 week
Stabilizer pressure biofeedback device	This device will be used to measure deep cervical flexor muscles endurance.	6 week
Stabilizer pressure biofeedback device	This device will be used to measure deep cervical flexor muscles endurance.	12 week

Collaborators and Investigators

• Sponsor: Bandırma Onyedi Eylül University

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2023
• Primary Completion (Actual): August 1, 2024
• Study Completion (Actual): August 1, 2024

Study Registration Dates

• First Submitted: July 13, 2023
• First Submitted That Met QC Criteria: July 27, 2023
• First Posted (Actual): July 28, 2023

Study Record Updates

• Last Update Posted (Estimated): August 27, 2025
• Last Update Submitted That Met QC Criteria: August 21, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: pain; Subacromial Impingement Syndrome; upper extremity function; Core Stabilization Exercises; range of motion; core stability; Impingement; core stabilization training; core stability exercises; Subacromial Impingement
• Additional Relevant MeSH Terms: Shoulder Injuries; Neurologic Manifestations; Musculoskeletal Diseases; Wounds and Injuries; Joint Diseases; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain; Shoulder Impingement Syndrome
• Other Study ID Numbers: 2023-29

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No