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Effect of Therapeutic Ultrasound Combined With Exercise on Subacromial Impingement Syndrome

30 giugno 2026 aggiornato da: Raquel A. Casarotto, University of Sao Paulo General Hospital

Effects of Therapeutic Ultrasound Combined With Exercise in the Rehabilitation of Individuals Diagnosed With Subacromial Impingement Pain Syndrome: a Randomized, Controlled, Double-blind Clinical Trial.

The aim of this study is to analyze the effects of Therapeutic Ultrasound combined with a Therapeutic Exercises program on pain reduction and improvement of function, range of motion (ROM), and functionality in individuals with Subacromial Impingement Syndrome. The main questions it aims to answer are:

Can the application of therapeutic ultrasound combined with exercise reduce pain and improve the ability to perform daily activities (functionality) in patients with Subacromial Impingement Syndrome? Does combining therapeutic ultrasound with exercise improve pain and functionality in patients with Subacromial Impingement Syndrome more effectively than using exercise alone to treat this syndrome? Researchers compared the application of therapeutic ultrasound combined with therapeutic exercises with placebo ultrasound (equipment programmed similarly to active ultrasound but emitting ultrasound waves) plus therapeutic exercises to determine if adding active ultrasound to the treatment is more effective than performing exercises alone in treating patients with Subacromial Impingement Syndrome.

Patients should be evaluated before the start of treatment, eight weeks after the start of treatment, and six months after the end of treatment.

Patients will receive therapeutic ultrasound or placebo combined with exercise 3 times a week for 8 weeks.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Introduction: Subacromial impingement syndrome (SIS)/Subacromial pain syndrome (SPS) is among the most common causes of pain and reduced shoulder functionality, characterized by repetitive impingement of structures located in the subacromial space, which anatomically comprises, superiorly, the acromion and inferiorly, the shoulder joint capsule and the subacromial bursa. Management of pathology includes numerous interventions, depending on the intensity of the pain and anatomopathological classification, involving conservative treatment (medications and physiotherapy) or surgical treatment in more severe cases. Objective: To verify the effects of therapeutic ultrasound (TUS), in continuous (USC) and pulsed (USP) modes, associated with a standardized therapeutic exercise (TE) program, on pain, range of motion, and functionality in individuals with shoulder pain associated with subacromial impingement syndrome (SIS). Methods: A randomized, controlled, double-blind clinical trial was conducted with 120 participants of both sexes, aged 30 to 75 years, with a clinical and ultrasound diagnosis compatible with subacromial impingement syndrome/rotator cuff-related shoulder pain. Participants were divided into four groups: (USC+TE), (USP+TE), placebo-controlled TUS associated with exercises (USPPL+TE), and isolated therapeutic exercises (TE)

Tipo di studio

Interventistico

Iscrizione (Effettivo)

120

Fase

  • Non applicabile

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Age between 30 and 75 years.
  • Clinical diagnosis compatible with subacromial pain syndrome.
  • Shoulder pain greater than 30 mm on the Visual Analog Scale.
  • Pain located in the anterolateral region of the shoulder, worsened during elevation of the upper limb.
  • At least three positive clinical tests among the following: Neer impingement sign, Hawkins-Kennedy impingement sign, painful arc between 60° and 120° of abduction, Jobe/empty can test, and resisted external rotation/infraspinatus test.
  • Ultrasonographic confirmation of findings compatible with subacromial pain syndrome.
  • Signed informed consent form.

Exclusion Criteria:

  • Previous surgery on the affected shoulder.
  • Suspected massive rotator cuff tear.
  • Positive drop-arm test.
  • Glenohumeral instability.
  • History of shoulder dislocation or subluxation.
  • Adhesive capsulitis/frozen shoulder.
  • Recent shoulder trauma.
  • Previous shoulder fracture with functional impairment.
  • Cervical radiculopathy with neurological signs.
  • Active inflammatory rheumatologic disease.
  • Uncontrolled hypertension.
  • Neoplasia.
  • Corticosteroid injection within the previous six months.
  • Physical therapy treatment for the shoulder within the previous six months.
  • Continuous use of analgesic or anti-inflammatory medication that could not be discontinued.
  • Contraindications to therapeutic ultrasound.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Doppio

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Continuous Ultrasound + Exercises
Participants will receive continuous therapeutic ultrasound combined with a standardized exercise program for the treatment of subacromial pain syndrome. The exercise program will include stretching, strengthening, and motor control exercises according to the study protocol.
Continuous therapeutic ultrasound applied to the shoulder region according to the study protocol combined with Standardized exercise program including stretching, strengthening, and motor control exercises for participants with subacromial pain syndrome.
Sperimentale: Pulsed Ultrasound + Exercises
Participants will receive pulsed therapeutic ultrasound combined with a standardized exercise program for the treatment of subacromial pain syndrome. The exercise program will include stretching, strengthening, and motor control exercises according to the study protocol.
Pulsed therapeutic ultrasound applied to the shoulder region according to the study protocol combined with standardized exercise program including stretching, strengthening, and motor control exercises for participants with subacromial pain syndrome..
Sperimentale: Placebo Ultrasound + Exercises
Participants will receive placebo therapeutic ultrasound combined with a standardized exercise program for the treatment of subacromial pain syndrome. The exercise program will include stretching, strengthening, and motor control exercises according to the study protocol.
Sham ultrasound applied using the same procedures as active ultrasound, without delivery of therapeutic energy combined with standardized exercise program including stretching, strengthening, and motor control exercises for participants with subacromial pain syndrome.
Sperimentale: Exercises Only
Participants will receive only a standardized exercise program for the treatment of subacromial pain syndrome. The exercise program will include stretching, strengthening, and motor control exercises according to the study protocol.
Standardized exercise program including stretching, strengthening, and motor control exercises for participants with subacromial pain syndrome.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Pain Intensity
Lasso di tempo: Baseline, Week 12, and Day 240.
Pain intensity was assessed using the Visual Analog Scale (VAS), separately for pain at rest and pain during activities of daily living (ADLs). The VAS ranges from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pain intensity.
Baseline, Week 12, and Day 240.
Shoulder pain and disability
Lasso di tempo: Baseline, Week 12, and Day 240.
Shoulder pain and disability were assessed using the Shoulder Pain and Disability Index (SPADI). The questionnaire consists of 13 items distributed across two domains: pain, with five items, and disability/function, with eight items. Each item is scored from 0 to 10. The total score and domain scores are converted into a percentage scale ranging from 0 to 100, with higher scores indicating worse shoulder pain and disability.
Baseline, Week 12, and Day 240.

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Functional shoulder performance
Lasso di tempo: Baseline, Week 12, and Day 240.
Functional shoulder performance was assessed using the Modified University of California at Los Angeles Shoulder Rating Scale (Modified UCLA Shoulder Rating Scale). The scale includes five domains: pain, function, active forward flexion range of motion, manual strength testing for forward flexion, and patient satisfaction. The total score ranges from 0 to 35 points, with higher scores indicating better shoulder function.
Baseline, Week 12, and Day 240.

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Investigatori

  • Investigatore principale: Raquel Aparecida Casarotto Casarotto, Associate Professor, University of Sao Paulo

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

1 gennaio 2017

Completamento primario (Effettivo)

1 dicembre 2020

Completamento dello studio (Effettivo)

1 dicembre 2020

Date di iscrizione allo studio

Primo inviato

24 giugno 2026

Primo inviato che soddisfa i criteri di controllo qualità

30 giugno 2026

Primo Inserito (Effettivo)

7 luglio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

7 luglio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

30 giugno 2026

Ultimo verificato

1 giugno 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • 88222424.4.0000.0068

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

SÌ

Descrizione del piano IPD

All collected individual data underpinning the results of a publication will be made available.

Periodo di condivisione IPD

The study data are in the final stage of analysis and will be made publicly available from October 2026 to October 2029.

Criteri di accesso alla condivisione IPD

Os dados do estudo serão disponibilizados através de contato com a pesquisadora Patrícia Pereira Alfredo. Estarão disponíveis as tabelas e dados sociodemográficos, bem como a metodologia de análise estatística realizada.

Tipo di informazioni di supporto alla condivisione IPD

  • RSI

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .