TECAR With Shoulder Chronic Shoulder Impingement Syndrome (TECAR /SIS)

Patients will receive TECAR therapy and conventional exercise for 6 weeks (3 sessions per week), consisting of 2 sessions per week of TECAR therapy and conventional exercises, and one session of conventional exercises only at-home exercises

TECAR therapy:

Received for 8 sessions during the intervention period. Each session consisted of 20 minutes: 10 minutes in capacitive mode at 100 W, followed by 10 minutes in resistive mode at 200 W. The device was operated at a pulsed frequency,

The program included three stretching exercises to address soft tissue restriction. It specifically targeted the upper trapezius, pectoralis minor, and posterior shoulder capsule. Each stretch was held for 30 seconds and repeated three times, with 30 seconds between repetitions Following the stretching exercises, participants completed a progressive strengthening program targeting the rotator cuff muscles and scapular stabilization. Participants performed strengthening exercises using color-coded elastic resistance bands, with 3 sets of 10 repetitions and 1 minute of rest between sets. Rotator cuff strengthening consisted of shoulder flexion, Abduction, External rotation, and Internal Rotation exercises.

Scapular stabilization exercises included serratus anterior, middle trapezius, and lower trapezius muscle strengthening)

Patients will receive Sham TECAR therapy and conventional exercise for 6 weeks (3 sessions per week), consisting of 2 sessions per week of Sham TECAR therapy and conventional exercises, and one session of conventional exercises only at-home exercises Both groups completed an identical exercise program consisting of stretching, strengthening, and Scapular stabilization

sham treatment by TECAR device for 20 min without producing any waves.

The program included three stretching exercises to address soft tissue restriction. It specifically targeted the upper trapezius, pectoralis minor, and posterior shoulder capsule. Each stretch was held for 30 seconds and repeated three times, with 30 seconds between repetitions Following the stretching exercises, participants completed a progressive strengthening program targeting the rotator cuff muscles and scapular stabilization. Participants performed strengthening exercises using color-coded elastic resistance bands, with 3 sets of 10 repetitions and 1 minute of rest between sets. Rotator cuff strengthening consisted of shoulder flexion, Abduction, External rotation, and Internal Rotation exercises.

Scapular stabilization exercises included serratus anterior, middle trapezius, and lower trapezius muscle strengthening)

The NPRS was used to assess the patient's shoulder pain intensity. Patients rated their current pain level on an 11-point scale from 0 (no pain) to 10 (worst pain imaginable). Ask participants to mark the point on the pain intensity scale

The SPADI test consists of 13 items divided into two domains: the pain domain (5 items) and the disability domain (8 items). Each item is assigned a value from 0 to 10 on the NRS; the score ranges from 0 (no difficulty) to 10 (unable to perform). All the responses' ratings will be added and divided by the number of questions in that subscale. The total SPADI score will be calculated as the average of the 2 subscales

Clinometer application was used to measure shoulder ROM. The patient stands during shoulder flexion and abduction and is supine on the plinth when measuring internal and external rotation; the shoulder is abducted to 90°, the elbow bent to 90 °, and the forearm is in a neutral position.

Isometric shoulder joint muscle strengths (flexion, abduction, external rotation) were measured with an HHD. The patient performs a maximal isometric muscle contraction for 3 seconds while the hand-held dynamometer is attached. The measurement is repeated three times, with a 30-second rest period between each measurement.