Cervical Unilateral Antero-posterior Mobilization and Thoracic Central Postro-anterior Mobilization in Treatment of Shoulder Impingement Syndrome

The Addition of Cervical Unilateral Antero-posterior Mobilization and Thoracic Central Postro-anterior Mobilization to Selected Therapeutic Exercise Program in Treatment of Shoulder Impingement Syndrome: A Randomized Clinical Trial

Shoulder impingement syndrome (SIS) is a complex, multi-factorial problem that is treated with a variety of different conservative options. The conservative option that has shown effectiveness is manual therapy of the cervical and thoracic spine

Study Overview

• Status: Completed
• Conditions: Shoulder Impingement
• Intervention / Treatment: Other: mobilization exercise; Other: therapeutic exercises

Detailed Description

This study will be conducted to answer the following question:

What is the effect of adding cervical and thoracic mobilization to selected therapeutic exercise Program on pain intensity, Pain-free shoulder flexion and scaption active ROM, muscle strength of external rotator and abductors, shoulder functional status in patients with Shoulder Impingement Syndrome

• Study Type: Interventional
• Enrollment (Actual): 56
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt, 11835
    • Faculty of Physical Therapy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion criteria required at least three positive findings from five diagnostic tests for SIS (Hawkins-Kennedy test, Neer's test, painful arc, Resisted External Rotation test, Jobe's test) and persistent shoulder pain (anterolateral shoulder region) for 3 to 6 months, along with limitations in functional movements as Individuals who experienced painful restrictions in their ability to raise their shoulder (flexion, abduction, scaption) and had pain or limitations when performing functional movements such as reaching behind their back or behind their head. As well as subjects who willingly participated in the study and gave their consent for the research purposes.

Exclusion criteria included adhesive capsulitis, radiologically confirmed grade III rotator cuff tears, calcific tendinitis, neurological or systemic disorders, cervical radiculopathy, prior shoulder surgery, recent corticosteroid injections, or recent physiotherapy within the previous three months. Patients complain from shoulder pain without pain on palpation, mobility limitations or pain during provocative tests, but complaining of abdominal tenderness on palpation were also excluded from this study.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Therapeutic exercises; a specific therapeutic exercise program consisted of stretching exercises for posterior capsule and progressive resistance exercises for rotator cuff and scapula stabilizer and home exercise	Other: therapeutic exercises; One group received an exercise program that consisted of pain control, ROM, as well as education in scapular control, strengthening of muscles around the shoulder blades, and starting sensory-motor training. The program consisted of all exercises being performed in 3 sets of 15 repetitions. also, scapular stabilizing exercise were added
Active Comparator: cervical and thoracic mobilization; cervical unilateral antero-posterior mobilization and thoracic central postro-anterior mobilization added to therapeutic exercises	Other: mobilization exercise; cervical unilateral antero-posterior mobilization and thoracic central postro-anterior mobilization

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pain intensity	pain intensity will be measured by visual analogue scale	pre intervention and after 6 weeks of intervention
shoulder flexion and abduction range of motion	measurement of shoulder flexion and abduction range of motion applied by using digital goniometer	pre intervention and after 6 weeks of intervention
muscle strength	shoulder flexors and external rotators muscle strength will be measured by dynamometer	pre intervention and after 6 weeks of intervention

Collaborators and Investigators

• Sponsor: Egyptian Chinese University
• Collaborators: Benha University
• Investigators: Principal Investigator: Noha Elserty, Benha University

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2024
• Primary Completion (Actual): July 1, 2024
• Study Completion (Actual): July 26, 2024

Study Registration Dates

• First Submitted: April 1, 2024
• First Submitted That Met QC Criteria: April 4, 2024
• First Posted (Actual): April 5, 2024

Study Record Updates

• Last Update Posted (Actual): April 15, 2026
• Last Update Submitted That Met QC Criteria: April 12, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Shoulder Injuries; Musculoskeletal Diseases; Wounds and Injuries; Joint Diseases; Shoulder Impingement Syndrome; Therapeutics; Physical Therapy Modalities; Patient Care; Rehabilitation; Aftercare; Continuity of Patient Care; Exercise Therapy
• Other Study ID Numbers: collage of physical therapy

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No