Title of This Study is to Evaluate the Effects of Abdominal Drawing in Maneuver With Cross Pattern Limb Exercises in Patients With Subacromial Impingement Syndrome

Effects of Abdominal Drawing-In Maneuver With Cross-Pattern Limb Exercises on Pain, Disability, and Range of Motion in Shoulder Impingement Syndrome.

SUMMARY :

Introduction: Shoulder impingement syndrome is a slowly progressive disease.Among people with shoulder pain, shoulder impingement syndrome (SIS) has the highest prevalence and accounts for 36% of shoulder disorders.Most studies have examined the effect of stretching and strengthening exercises on the glenohumeral joint (shoulder joint).

Objective:The objective of this study is to determine the effect of the Abdominal Drawing-In Maneuver combined with Cross-Pattern Limb Exercises on pain and disability and range of motion in patients with Shoulder Impingement Syndrome.

Methodology: This study will be Randomized Controlled Trial and 38 subjects will be taken for the study those who fulfills the inclusion criteria. They will be randomly divided into two groups, in control group only conventional treatment and in experimental trial group, conventional treatment as well as abdominal drawing in maneuver with cross pattern limb exercises will be given. Each subject of the study will be treated for a period of 4 weeks, 3 days a week, one session per day. An assessment will be done prior to starting of treatment, after 4 weeks of treatment, again assessment will be taken for these subjects. Pain and disability is measured by using NPRS, SPADI and range of motion flexion, abduction, external rotation and internal rotation will be measured by using Goniometer. The data will be analyzed using SPSS version 25, quantitative variables will be presented using mean, standard deviation, range, histograms. Categorical variables will be presented as frequencies, percentages, cross tabulation and bar charts, pie charts. Normality of data will be analyzed by shapiro-wilk test. Parametric independent t-test will be used to check difference between the groups and paired t-test will be used to find difference within the group.

Study Overview

• Status: Active, not recruiting
• Conditions: Shoulder Impingement Syndrome
• Intervention / Treatment: Other: Abdominal Drawing Inn maneuver with cross pattern limb exercises; Other: Shoulder Exercises

• Study Type: Interventional
• Enrollment (Actual): 38
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 53720
      • Suyperior Univeristy

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

1. Patients with age group 30-50
2. Both male and females
3. Positive Neer's sign, positive Hawkins Kennedy sign, ,
4. Pain with positive painful arc. Pain with resisted isometric abduction

Exclusion Criteria:

1. History of shoulder dislocation
2. Patients underwent any shoulder joint surgery.
3. Fracture of upper limb.
4. Patient who has current symptoms related to the cervical spine,
5. Patient who has a history of acromioclavicular pain
6. Patient having history low back pain 7Corticosteroid injection into the shoulder joint in the previous 12 months

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: Experimental group with abdominal Drawing in maneuvour with cross pattern limb exercises; Heating pad will be applied over the shoulder area for about 15 minutes at the start of each session. The intervention plan will be given as follows: Abdominal drawing-in with alternating upper extremity movement, (The patient will lie in supine position and draw his abdomen downwards and will move his alternate upper extremity upwards.; Abdominal drawing-in with alternating lower extremity movement, (The patient will lie in supine position and draw his abdomen downwards and will move his alternate lower extremity upward and downwards; Abdominal drawing-in with alternating upper and lower extremity movement, (The patient will lie in supine position and draw his abdomen downwards and move alternate upper and lower extremity upward and downwards.; Opposite arm leg raises in prone position; Bridge exercise; Wall climbing,; Wand exercises,; Shoulder ROMS,; Prone arm elevation,; Cross-Chest Stretch; Pendulum Exercises	Other: Abdominal Drawing Inn maneuver with cross pattern limb exercises; Abdominal drawing-in with alternating upper extremity movement,; Abdominal drawing-in with alternating lower extremity movement,; Abdominal drawing-in with alternating upper and lower extremity movement,; Opposite arm leg raises in prone position,; Bridge exercise
Active Comparator: Conventional Study group; Half of the particpants will be treated with only shoulder conventional exercises. Heating pad will be applied over the shoulder area for about 15 minutes at the start of each session. Following exercises will be performed in control group: Wall climbing,; Wand exercises,; Shoulder ROMS,; Prone arm elevation,; Cross-Chest Stretch Pendulum Exercises	Other: Shoulder Exercises; The participants in conventional group will only receive shoulder exercises that will include Wall climbing, Wand exercises, Shoulder ROMS, Prone arm elevation, Cross-Chest Stretch Pendulum Exercises

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
NPRS	It is numeric pain rating scale ranging from 0-10. Patient will rate his pain from 0-10 with 0 means no pain and 10 with severe pain.	The pain assessment is done pre treatment on day 1 week 1 before 1st session and second assessment is done on 12th sesion after 4 weeks
Shoulder Pain and Disability Index	SPADI scale consists of 5 questions with 10 points each related to pain and 8 question related to disability with 10 points each totalling 140 points.	The assessment is taken pre treatment day 1 week 1 before 1st session and second assessment is taken on 12th session after 4 weeks
Goniometry	Goniometry is used to assess range of motion. Goniometer is used to measure it. Flexion, abduction, internal and external rotations are measured using goniometer.	Range of motion is assessed pre treatment on day 1 week 1 before 1st session and 2nd assessment is taken on 12th session after 4 weeks.

Collaborators and Investigators

• Sponsor: Superior University

Study record dates

Study Major Dates

• Study Start (Actual): February 20, 2026
• Primary Completion (Estimated): April 20, 2026
• Study Completion (Estimated): April 20, 2026

Study Registration Dates

• First Submitted: March 24, 2026
• First Submitted That Met QC Criteria: April 7, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 7, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Disability; Range of motion; Shoulder pain; Shoulder impingement syndrome; Abdominal drawing in maneuver
• Additional Relevant MeSH Terms: Shoulder Injuries; Pain; Neurologic Manifestations; Musculoskeletal Diseases; Wounds and Injuries; Joint Diseases; Arthralgia; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Shoulder Pain; Shoulder Impingement Syndrome
• Other Study ID Numbers: Superior University

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