Scapular Repositioning for Neck Pain and Scapular Dysfunction

Effects of Scapular Repositioning on Pain, Range of Motion, Proprioception, and Pressure Pain Threshold in Patients With Neck Pain and Scapular Dysfunction

This randomized controlled trial is designed to evaluate the effects of scapular repositioning in individuals with neck pain and scapular dysfunction. The main questions it aims to answer are:

1. Does scapular repositioning reduce neck pain, increase range of motion, and improve joint position sense and pressure pain threshold?
2. Which type of scapular repositioning technique is more effective?

Participants will be randomly assigned to one of three groups:

1. Active scapular repositioning: The examiner will first passively position the scapula in a neutral position on the posterior chest wall. The participant will then be instructed to actively maintain that position for 10 seconds. This procedure will be repeated for 10 repetitions, with a 10-second rest interval between each repetition.
2. Passive scapular repositioning: The examiner will passively position and hold the scapula in a neutral position for 10 seconds. This procedure will be repeated for 10 repetitions, with a 10-second rest interval between each repetition.
3. Sham scapular repositioning (control): The examiner will perform gentle shoulder movements that do not alter scapular positioning. Each movement will be held for 10 seconds, repeated 10 times, with a 10-second rest interval between repetitions.

All participants will undergo pre- and post-intervention assessments (immediately after the intervention and at 30 minutes post-intervention). The primary outcomes include neck pain intensity, cervical range of motion, cervical and shoulder proprioception, and pressure pain threshold. All outcomes will be compared between groups and across time points (pre- and post-intervention).

Study Overview

• Status: Completed
• Conditions: Neck Pain; Scapular Dyskinesis
• Intervention / Treatment: Behavioral: Active scapular repositioning; Procedure: Passive scapular repositioning; Procedure: Sham scapular repositioning

• Study Type: Interventional
• Enrollment (Actual): 78
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Thailand
  • Changwat Phayao
    • Phayao, Changwat Phayao, Thailand, 56000
      • School of Allied Health Sciences, University of Phayao

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Chronic idiopathic neck pain for ≥3 months
• An average pain intensity over the past week ≥3 mm on a Visual Analogue Scale (VAS)
• A current score of at least 10/100 on the Neck Disability Index-Thai version
• Having altered scapular alignment ipsilateral to the more painful side of neck pain

Exclusion Criteria:

• History of neck injury or surgery
• History of shoulder girdle pain, fracture, surgery or dislocation
• History of neurological conditions (e.g. stroke, Parkinson's disease, brachial plexus injury)
• History of marked spinal abnormalities (e.g. kyphosis, scoliosis) and other musculoskeletal conditions that could affect the scapular movement (e.g. myofascial pain syndrome, fibromyalgia, inflammatory joint disease, and/or autoimmune diseases)
• Have participated in any specific training of the neck or shoulder girdle muscles in the last 6 months

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Active scapular repositioning; Self-active scapular repositioning exercise	Behavioral: Active scapular repositioning; The examiner will first passively position the participant's scapula in a neutral position on the posterior chest wall. The participant will then be instructed to actively maintain that position.
Experimental: Passive scapular repositioning; Therapist-assisted scapular repositioning	Procedure: Passive scapular repositioning; The examiner will passively position and hold the participant's scapula in a neutral position.
Sham Comparator: Sham scapular repositioning; Sham scapular repositioning procedure	Procedure: Sham scapular repositioning; The examiner will perform gentle shoulder girdle movements that do not alter scapular positioning.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neck pain intensity	Neck pain intensity measured by the Visual Analog Scale (VAS; 0-100 mm, where higher scores indicate worse pain).	Baseline, immediately after the intervention and at 30 minutes post-intervention
Cervical range of motion	Cervical range of motion measured using a goniometer in flexion, extension, left and right lateral flexion, and left and right rotation (measured in degrees).	Baseline, immediately after the intervention and at 30 minutes post-intervention
Cervical and shoulder proprioception	Cervical joint position error (JPE) measured using a laser pointer mounted on a headband at the center of the head during blindfolded active extension and left/right rotation. Shoulder joint position error (JPE) measured using a laser pointer placed proximal to the lateral epicondyle during blindfolded active shoulder flexion and abduction. An absolute error between starting and return positions will be recorded in millimeters and converted to degrees. Higher values indicate greater impairment.	Baseline, immediately after the intervention and at 30 minutes post-intervention
Pressure pain threshold at upper trapezius and levator scapulae muscles	Pressure pain threshold (PPT) measured by algometer; values recorded in Newtons (N), with lower scores indicating greater pain sensitivity (worse outcome).	Baseline, immediately after the intervention and at 30 minutes post-intervention

Collaborators and Investigators

• Sponsor: University of Phayao

Study record dates

Study Major Dates

• Study Start (Actual): August 10, 2025
• Primary Completion (Actual): December 19, 2025
• Study Completion (Actual): December 19, 2025

Study Registration Dates

• First Submitted: June 27, 2025
• First Submitted That Met QC Criteria: July 16, 2025
• First Posted (Actual): July 24, 2025

Study Record Updates

• Last Update Posted (Actual): May 27, 2026
• Last Update Submitted That Met QC Criteria: May 25, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Exercise; Intervention; Neck pain; Scapular dysfunction; Scapular repositioning
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Behavior; Signs and Symptoms; Neck Pain; Motor Activity
• Other Study ID Numbers: HREC-UP-HSST 1.2/073/68

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