The Effect of a Dual-Task Technique-Based Exercise Program on Clinical Outcomes in Rotator Cuff Related Shoulder Pain

The aim of this clinical trial is to investigate the effects of a dual-task-based exercise program on clinical outcomes in individuals with rotator cuff-related shoulder pain. The study will evaluate the effects of a dual-task exercise approach, in which physical exercises are performed concurrently with cognitive tasks, on pain, functional status, pain catastrophizing and kinesiophobia. These results will be compared with those of a standard shoulder rehabilitation program. The main questions this study aims to answer are:

• Is there a difference in pain levels between individuals with rotator cuff-related shoulder pain who participate in a dual-task-based exercise program and those who participate in a standard exercise program?
• Is there a difference between these two exercise approaches in terms of shoulder function and psychosocial factors?

Participants will:

• Participate in either a dual-task-based shoulder exercise program or a standard shoulder exercise program twice per week for 6 weeks.
• Undergo clinical assessments at baseline, at week 6, and at week 12.

Study Overview

• Status: Recruiting
• Conditions: Subacromial Pain Syndrome; Shoulder Pain Syndrome; Rotator Cuff Related Shoulder Pain
• Intervention / Treatment: Other: Patient Education; Other: Dual-Task-Based Exercise Therapy; Other: Standard Exercise Therapy

Detailed Description

A total of 46 patients will be included in the study based on the results of a power analysis. Participants will be randomly allocated into two groups using a computer-based randomization program: the Dual-Task Technique-Based Exercise Group (Group 1) and the Standard Exercise Group (Group 2). Both groups will receive patient education and participate in a supervised exercise program. In the Dual-Task Technique-Based Exercise Group, exercise sessions will be performed concurrently with cognitive tasks. The Standard Exercise Group will undergo a standard shoulder exercise program without cognitive task integration. The intervention will be administered twice per week for a total of 12 sessions over a 6-week period. Clinical assessments will be conducted for both groups at baseline (before treatment), at the end of the intervention (week 6), and at week 12 as a follow-up assessment. The primary outcome measure will be pain intensity, assessed using the Numeric Pain Rating Scale (NPRS). Secondary outcome measures will include the Quick Disabilities of the Arm, Shoulder and Hand questionnaire (Q-DASH), the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), the Pain Catastrophizing Scale (PCS) and the Tampa Scale of Kinesiophobia-11 (TSK-11).

• Study Type: Interventional
• Enrollment (Estimated): 46
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: İrem Ece İçöz, Bachelor's degree; Phone Number: 90+ 5511040686; Email: iremece.icoz@ogr.iuc.edu.tr

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • Recruiting
    • Istanbul University-Cerrahpaşa

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Aged between 18 and 65 years
• Diagnosis of impingement syndrome, subacromial bursitis, rotator cuff tendinopathy, or partial rotator cuff tear
• Shoulder pain level ≥3 according to the Numeric Pain Rating Scale (NPRS)
• Shoulder pain persisting for at least 3 months

Exclusion Criteria:

• Diagnosis of shoulder instability, adhesive capsulitis, or full-thickness or massive rotator cuff tear
• Presence of musculoskeletal, neurological, and/or psychological conditions that would prevent participation in an exercise program
• History of shoulder surgery
• Having received physiotherapy or corticosteroid injection treatment for shoulder pain within the past 6 months
• Presence of cognitive impairment that would prevent participation in dual-task exercise activities

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: Dual-Task Technique-Based Exercise Group; Patients will receive a treatment program consisting of patient education and exercise therapy twice per week for a total of 12 sessions. Exercise sessions will be performed concurrently with cognitive tasks.	Other: Patient Education; Participants will receive patient education on basic muscle biomechanics, causes of pain, pain management strategies, and proper sleeping positions.; Other: Dual-Task-Based Exercise Therapy; Participants will be enrolled in a structured exercise program consisting of exercises recommended in the literature. The program will include a three-phase exercise protocol comprising range of motion exercises, stretching exercises, and strengthening exercises. In addition to the standard shoulder exercise program, participants will perform concurrent cognitive tasks targeting attention, cognitive processing, working memory, and verbal fluency. The exercise program will be delivered under the supervision of a physiotherapist twice per week over a 6-week period.
Active Comparator: Standard Exercise Group; Patients will receive a treatment program consisting of patient education and exercise therapy twice per week for a total of 12 sessions, following a standard shoulder exercise approach.	Other: Patient Education; Participants will receive patient education on basic muscle biomechanics, causes of pain, pain management strategies, and proper sleeping positions.; Other: Standard Exercise Therapy; Participants will be enrolled in a structured exercise program consisting of exercises recommended in the literature. The program will include a three-phase exercise protocol comprising range of motion exercises, stretching exercises, and strengthening exercises. The exercise program will be delivered under the supervision of a physiotherapist twice per week over a 6-week period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric Pain Rating Scale (NPRS)	NPRS will be used to evaluate pain levels. The scale consists of a numeric rating system ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain." Participants will be asked to rate the intensity of their shoulder pain.	At baseline, at week 6, and at week 12

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quick Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH)	QuickDASH is an 11-item self-reported questionnaire used to assess the ability to perform specific upper extremity activities. Participants rate each item on a 5-point Likert scale. Total scores range from 0 to 100, with higher scores indicating greater functional disability.	At baseline, at week 6, and at week 12
The American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES)	ASES is a questionnaire consisting of a patient-reported pain component assessed using a visual analog scale and a functional component including 10 items related to activities of daily living. The total score ranges from 0 to 100. Higher scores indicate better functional ability.	At baseline, at week 6, and at week 12
Pain Catastrophizing Scale (PCS)	PCS is a self-reported questionnaire used to assess cognitive processes related to pain. It consists of 13 items, each rated on a 5-point Likert scale. Total scores range from 0 to 52. Higher scores indicate greater levels of pain catastrophizing.	At baseline, at week 6, and at week 12
Tampa Scale of Kinesiophobia-11 (TSK-11)	TSK-11 is the most commonly used shortened version of the Tampa Scale of Kinesiophobia and is used to assess fear of movement or re-injury. It consists of 11 items, each rated on a 4-point Likert scale. Total scores range from 11 to 44. Higher scores indicate greater fear of movement.	At baseline, at week 6, and at week 12

Collaborators and Investigators

• Sponsor: Istanbul University

Study record dates

Study Major Dates

• Study Start (Actual): February 16, 2026
• Primary Completion (Estimated): February 16, 2027
• Study Completion (Estimated): June 16, 2027

Study Registration Dates

• First Submitted: February 10, 2026
• First Submitted That Met QC Criteria: February 10, 2026
• First Posted (Actual): February 17, 2026

Study Record Updates

• Last Update Posted (Actual): April 20, 2026
• Last Update Submitted That Met QC Criteria: April 15, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Shoulder pain; Rotator cuff; Dual-task exercise
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Joint Diseases; Arthralgia; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Shoulder Pain; Health Services; Health Care Facilities Workforce and Services; Preventive Health Services; Health Education; Patient Education as Topic
• Other Study ID Numbers: 2190016

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