Thoracic Manipulation Versus Myofascial Release in Patients With Shoulder Impingement Syndrome

NCT05104671 | Completed

• 1 other identifier: shoulder impingement
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

aims: • To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on pain intensity.

• To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on pain pressure threshold.
• To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on shoulder proprioception.
• To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on shoulder range of motion(ROM).
• To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on disability of shoulder and hand questionnaire(DASH).

Conditions

Impingement Shoulder

Outcome Measures

Primary Outcomes (3)

• Pain in shoulder movement

  will be measured by Visual analog scale(VAS). It consists of a line, often 10 cm long(100mm); its ends are generally labelled with verbal pain anchors (e.g., "no pain" and "pain as bad as it could be"). Patients are asked to indicate the point along the line that best reflects their pain intensity. The majority of the studies showed that visual analogue scale is a valid and reliable scale. Also, it is an interval scale. So, in clinical practice we can use this scale in case of pain measurement as an outcome measure tool.

  change from max pain point at 2 months

• shoulder function

  by DASH is a reliable and valid tool for the assessment of shoulder pain and disability in both clinical practice and research.

  change from limitation of function at 2 months

• Shoulder Proprioception (joint of position error)

  will be measured by isokinetic dynamometer. Isokinetic dynamometry is considered a valid instrument for assessing muscle strength, and it is often used as a reference standard for other strength assessments.

  change from poor proprioception at 2 months

Secondary Outcomes (2)

• Shoulder ROM

  change from limitation in shoulder ROM at 2 months

• Pain pressure threshold in shoulder muscles

  change from baseline pain pressure threshold at 2 months

Study Arms (3)

Scapular stabilization exercises

ACTIVE COMPARATOR

Group I (control group) will receive scapular stabilization exercises.

Other: scapular stabilization exercises.

Thoracic manipulation.

EXPERIMENTAL

Group II will receive scapular stabilization exercises and thoracic manipulation.

Other: scapular stabilization exercises.; Other: Thoracic manipulation.

Myofascial release

EXPERIMENTAL

Group III will receive scapular stabilization exercises and myofascial release by instrument assisted soft tissue mobilization techniques.

Other: scapular stabilization exercises.; Other: Myofascial release.

Interventions

scapular stabilization exercises. OTHER

General Instructions: For all exercises, perform the retraction of the scapula, without performing the elevation of the shoulders, taking the lower angle of the scapula "back and down". The exercise intensity was described as repetitions, sets, and holding time. Commonly, 10-20 repetitions and three to five sets held for 3-10 seconds were performed.and the exercises will be: 1. towel slide 2. Scapular Clock: 3. Scapular Proprioceptive Neuromuscular facilitation: 4. Inferior Glide. 5. Scapular Orientation Exercise (SOE): 6. Protraction and retraction in front of a mirror:

Myofascial release; Scapular stabilization exercises; Thoracic manipulation.

Thoracic manipulation. OTHER

• Thoracic Thrust Manipulation: The participants were in high sitting and in prone lying position. The therapist was standing next to the patient in a diagonal stance and also behind the patient during high sitting. Thoracic thrust manipulation demonstrated to manipulate specific thoracic segment mainly mid thoracic.

Also known as: scapular stabilization exercises

Thoracic manipulation.

Myofascial release. OTHER

The subject will be treated with IASTM.applied to the pectoral muscles and medial brachium with the subject in supine and the glenohumeral joint(GH). placed in 120 º abduction to place adequate tension on the selected tissues in the style of pectoral tightness test .The IASTM technique was performed for 20 seconds parallel to the muscle fibers followed by 20 seconds perpendicular to the muscle fibers with the instrument held at a 45 º angle to the skin.The same IASTM protocol of 20 seconds parallel to the muscle fibers and 20 seconds perpendicular to the muscle fibers was applied to the posterior cuff musculature of the GH joint with the subject in prone and arms in 90 º abduction and internal rotation draped over the side of the plinth . While in the same position, the technique was applied to the periscapular musculature including the, trapezoids, rhomboids, teres minor, teres major, and latissimus dorsi.

Also known as: scapular stabilization exercises

Myofascial release

Eligibility Criteria

• Age: 25 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Sixty patients with shoulder impingement syndrome from both genders their age will be ranged and divided into three groups from 25-40 years.
• History of shoulder pain for at least one month.
• Positive Neer's impingement test and Hawkins's kiennedy test.
• Presence of thoracic hypomobility from clinical evaluation.
• Provocation of pain above 60 degrees of flexion and abduction.
• Palpable trigger points on shoulder muscles.

You may not qualify if:

• History of Shoulder girdle fracture, dislocation and surgery
• Diagnosed with frozen shoulder or rotator cuff tear
• History of cervicobrachial pain
• Any neuromuscular pain in upper limb and use of corticosteroids or pain subsiding medication

Sponsors & Collaborators

• manar sameh el taher: lead
• Cairo University: collaborator

Study Sites (1)

Cairo University

Cairo, Egypt

Location

MeSH Terms

Conditions

Shoulder Impingement Syndrome

Interventions

Myofascial Release Therapy

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Massage; Therapy, Soft Tissue; Musculoskeletal Manipulations; Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Researcher

Study Record Dates

• First Submitted: July 18, 2021
• First Posted: November 3, 2021
• Study Start: December 1, 2021
• Primary Completion: May 15, 2023
• Study Completion: May 15, 2023
• Last Updated: July 24, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)