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Effect of Therapeutic Ultrasound Combined With Exercise on Subacromial Impingement Syndrome

2026年6月30日 更新者: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.

調査の概要

詳細な説明

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)

研究の種類

介入

入学 (実際)

120

段階

  • 適用できない

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

説明

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.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:ダブル

武器と介入

参加者グループ / アーム
介入・治療
実験的: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.
実験的: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..
実験的: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.
実験的: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.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Pain Intensity
時間枠: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
時間枠: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.

二次結果の測定

結果測定
メジャーの説明
時間枠
Functional shoulder performance
時間枠: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.

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:Raquel Aparecida Casarotto Casarotto, Associate Professor、University of Sao Paulo

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2017年1月1日

一次修了 (実際)

2020年12月1日

研究の完了 (実際)

2020年12月1日

試験登録日

最初に提出

2026年6月24日

QC基準を満たした最初の提出物

2026年6月30日

最初の投稿 (実際)

2026年7月7日

学習記録の更新

投稿された最後の更新 (実際)

2026年7月7日

QC基準を満たした最後の更新が送信されました

2026年6月30日

最終確認日

2026年6月1日

詳しくは

本研究に関する用語

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

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

IPD 共有時間枠

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

IPD 共有アクセス基準

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.

IPD 共有サポート情報タイプ

  • CSR

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米国FDA規制機器製品の研究

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