Effect of Scapular Stabilization Exercises on Pain and Functional Outcomes in Subacromial Impingement Syndrome: A Randomized Controlled Trial

Effect of Scapular Stabilization Exercises on Functional Outcomes in the Treatment of Subacromial Impingement Syndrome: A Controlled Clinical Study

This randomized controlled study aims to evaluate the effects of scapular stabilization exercises on pain, shoulder function, and quality of life in patients with subacromial impingement syndrome. Participants will be randomly assigned to either a scapular stabilization exercise program or a conventional shoulder rehabilitation program. Pain, functional outcome measures, and patient-reported quality of life will be assessed at baseline, 4 weeks, and 12 weeks. The study seeks to determine whether adding scapular stabilization exercises provides superior clinical benefit.

Study Overview

• Status: Completed
• Conditions: Subacromial Impingement Syndrome
• Intervention / Treatment: Other: Standard Physiotherapy

Detailed Description

Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain and functional limitation. Scapular dyskinesis plays a key role in the development and persistence of SIS by altering scapulohumeral rhythm and increasing mechanical stress on subacromial tissues. Scapular stabilization exercises are increasingly used to restore normal scapular mechanics, improve muscular control, and reduce pain, but the clinical effectiveness of these exercises compared to conventional rehabilitation programs remains unclear.

This prospective, single-blind randomized controlled study investigates the effects of a scapular stabilization exercise program on pain, functional outcomes, and quality of life in patients diagnosed with SIS. Participants are randomly allocated to either a scapular stabilization group or a conventional shoulder rehabilitation group. Pain (VAS), functional status (QuickDASH and SPADI), range of motion, and quality-of-life measures are assessed at baseline, 4 weeks, and 12 weeks. The study aims to determine whether adding scapular stabilization exercises to standard rehabilitation leads to superior clinical improvement compared to conventional therapy alone.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye), 34303
    • Kanuni Sultan Suleyman Training and Research Hospital

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Adults aged 18 to 65 years.
• Clinically diagnosed subacromial impingement syndrome (SIS) based on:positive Neer test ,positive Hawkins-Kennedy test ,painful arc between 60°-120°,pain during resisted shoulder tests
• Symptoms present for at least 4 weeks.
• Ability to comply with a 12-week supervised rehabilitation program.
• Ability to provide written informed consent.

Exclusion Criteria:

• Previous shoulder surgery on the affected side.
• Presence of full-thickness rotator cuff tear confirmed by ultrasound imaging.
• Evidence of cervical radiculopathy or significant cervical spine pathology.
• Advanced glenohumeral or acromioclavicular osteoarthritis.
• History of inflammatory rheumatic diseases (e.g., rheumatoid arthritis, ankylosing spondylitis).
• Severe cardiopulmonary, neurological, or systemic conditions limiting physical activity.
• Recent shoulder fracture or dislocation (< 6 months).
• Participation in another structured shoulder rehabilitation program within the last 3 months.
• Pregnancy.
• Inability to understand or follow instructions required for the intervention or assessments.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Standard Physiotherapy; Participants in this arm receive standard physiotherapy consisting of electrotherapy, range-of-motion exercises, and stretching. The program is administered three times per week for 12 weeks. No scapular-specific stabilization or mobilization exercises are included. All participants also receive a home exercise program for daily stretching and mobility exercises.	Other: Standard Physiotherapy; Standard physiotherapy consisting of electrotherapy modalities, range-of-motion exercises, and stretching exercises. The program is administered three times per week for 12 weeks. The intervention does not include any scapular-specific stabilization or mobilization techniques. All participants receive a home exercise program including daily stretching and mobility exercises.; Other Names: Conventional Physiotherapy, Routine Physiotherapy
Experimental: Scapular Stabilization + Mobilization-Based Rehabilitation; Participants receive the same standard physiotherapy as the control group, combined with a supervised scapular stabilization and mobilization-based rehabilitation program. This structured 12-week protocol (3 sessions per week) includes passive scapular mobilization (10-12 minutes per session) and a three-phase stabilization exercise progression targeting scapular mechanics, muscle activation, strength, and neuromuscular control. A daily home exercise program is also provided.	Other: Standard Physiotherapy; Standard physiotherapy consisting of electrotherapy modalities, range-of-motion exercises, and stretching exercises. The program is administered three times per week for 12 weeks. The intervention does not include any scapular-specific stabilization or mobilization techniques. All participants receive a home exercise program including daily stretching and mobility exercises.; Other Names: Conventional Physiotherapy, Routine Physiotherapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
1. Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) Score	QuickDASH is an 11-item validated questionnaire that measures physical function and symptoms related to upper extremity disorders. Total scores range from 0 to 100, with higher scores indicating greater disability. The primary outcome is the change in QuickDASH score from baseline to Week 12.	Baseline, Week 6, Week 12

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Modified Constant-Murley Score (CMS)	The Constant-Murley Score assesses shoulder pain (15 points), daily activities (20 points), range of motion (40 points), and strength (25 points). Total score ranges from 0 to 100, with higher scores indicating better function. The secondary outcome is the improvement in CMS over time.	Baseline, Week 6, Week 12
Visual Analog Scale (VAS)	Pain intensity at rest is measured using a 10-cm Visual Analog Scale (0 = no pain, 10 = worst pain). The outcome represents the change in resting pain levels over time.	Baseline, Week 6, Week 12

Collaborators and Investigators

• Sponsor: Kanuni Sultan Suleyman Training and Research Hospital
• Investigators: Principal Investigator: Zeynep Karakuzu Güngör, Kanuni Sultan Suleyman Training and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): August 30, 2025
• Primary Completion (Actual): November 30, 2025
• Study Completion (Actual): December 30, 2025

Study Registration Dates

• First Submitted: November 27, 2025
• First Submitted That Met QC Criteria: November 30, 2025
• First Posted (Estimated): December 11, 2025

Study Record Updates

• Last Update Posted (Actual): January 13, 2026
• Last Update Submitted That Met QC Criteria: January 11, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Exercise Therapy; Functional Outcomes; Shoulder Rehabilitation; Scapular Stabilization
• Additional Relevant MeSH Terms: Shoulder Injuries; Musculoskeletal Diseases; Wounds and Injuries; Joint Diseases; Shoulder Impingement Syndrome
• Other Study ID Numbers: impingement-2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared because data sharing is not planned for this study.

Drug and device information, study documents

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