Effect of Thoracic Mobility Exercises Combined With Scapular Stabilization Exercises in Individuals With Subacromial Pain Syndrome

NCT07043842 | Not Yet Recruiting

• 1 other identifier: 16.01.2025-01/1119
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

The subject of this study is to examine the effects of thoracic mobility exercises combined with scapular stabilization exercises on pain, range of motion, scapular alignment, postural alignment and quality of life in individuals with subacromial pain syndrome. The scapula assumes a role that is attached to the axial skeleton by atmospheric pressure and axioscapular muscles, and prepares the ground for the formation of wide range of motion in the shoulder complex. The scapulothoracic movement formed by the movement of the scapula on the thorax is provided not only by the function of the scapular muscles but also by the optimization of the thoracic muscles and posture. Therefore, changes in the biomechanics of the thoracic spine and scapula affect the function of the shoulder. Therefore, we predict that the possible contributions of scapular stabilization and thoracic mobility exercises to scapular alignment and alignment in thoracic posture will further improve shoulder-related complaints.

Conditions

Subacromial Pain Syndrome

Keywords

subacromial pain syndrome; scapular stabilization exercises; thoracic mobility exercises

Outcome Measures

Primary Outcomes (6)

• Assessment of pain intensity

  Pain intensity will be assessed with the Visual Analog Scale (VAS). Patients are asked to mark the intensity of pain they feel at rest, during elevation, and at night on the scale. The patient is asked to position the pain intensity between "No Pain at All" and "Very Severe Pain" at one end. The area from the point "0" where there is no pain to the point they mark is measured.

  Change from the initial level after the 6-week treatment program.

• Evaluation of joint range of motion

  Joint range of motion will be assessed with the smartphone goniometer application. Measurements will be made in the form of painless and painful active joint range of motion and passive joint range of motion assessments of the shoulder in all directions.

  Change from the initial level after the 6-week treatment program.

• Pectoralis minor shortness assessment

  While standing in a free standing position, the distance between the coracoid process of the scapula and the 4th rib will be measured with a tape measure. The determined length will be divided by the patient's height in cm and multiplied by 100 to obtain the pectoralis minor index (PMI).

  Change from the initial level after the 6-week treatment program.

• Scapular alignment assessment

  Lateral Scapular Slip Test (LSKT) will be used to assess scapular alignment. It is applied according to the procedure described by Kibler. Accordingly; 3 test positions are used. In the first position; The shoulder glenohumeral joint is in a neutral position, the humerus is in a medial rotation position with 45° abduction in the coronal plane in the second test position, and the shoulder is in a medial rotation position with 90° abduction in the coronal plane in the third test position. In the test where the distance of the scapula from the midline is measured; the horizontal distance from the T4 spinous process to the medial corner of the scapula is measured with a tape measure. A distance difference of 1.5 cm or more between the two sides is defined as positive LSKT by Kibler.

  Change from the initial level after a 6-week treatment program.

• Evaluation of thoracic kyphosis

  Thoracic kyphosis will be assessed with a smartphone inclinometer application. The short side of the smartphone is placed over the anatomical reference points (T1-T3, T12) marked on the spine. First, the phone is placed on the T1-T3 spinous process and the protractor is set to 0°, then the phone is placed on the T12 spinous process and the angular value displayed on the screen is recorded as the degree of kyphosis.

  Change from the baseline after a 6-week treatment program.

• Evaluation of shoulder-related quality of life

  Western Ontario Rotator Cuff Index (WORC): The WORC, whose Turkish adaptation has been shown to be reliable and valid, will be used to determine the effectiveness of rehabilitation on quality of life. It consists of 5 sections including physical symptoms, sports and leisure, work, lifestyle and emotional functions and a total of 21 questions. In the WORC index, evaluation results can be given as raw scores and one hundred points. The best possible score is 0 (% 100) and there is no decrease in the patient's shoulder-related quality of life; the worst possible score is 2100 (% 0) and the patient has a very significant decrease in the shoulder-related quality of life.

  Change from baseline after 6-week treatment program.

Study Arms (2)

Treatment group

EXPERIMENTAL

This group consists of patients who will undergo shoulder circumference exercises and scapular stabilization exercises along with thoracic mobility exercises.

Other: Shoulder circumference exercises; Other: Scapular stabilization exercises; Other: Thoracic mobility exercises

Control group

ACTIVE COMPARATOR

This group consists of patients who will undergo shoulder circumference exercises and scapular stabilization exercises.

Other: Shoulder circumference exercises; Other: Scapular stabilization exercises

Interventions

Shoulder circumference exercises OTHER

They are strengthening and stretching exercises that support the range of motion of the shoulder joint.

Control group; Treatment group

Scapular stabilization exercises OTHER

Changes in the biomechanics of the scapula affect the function of the shoulder. Biomechanical correction will be attempted with these exercises aimed at correcting the posture of the scapula.

Control group; Treatment group

Thoracic mobility exercises OTHER

Changes in the biomechanics of the thoracic spine affect the function of the shoulder. Biomechanical correction will be attempted with these exercises aimed at correcting the posture of the thoracic spine.

Treatment group

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Volunteering to participate in the study
• Being between the ages of 18-60
• Being diagnosed with subacromial pain syndrome
• Having Stage I or Stage II subacromial pain syndrome according to Neer
• Having unilateral shoulder pain that limits activity for more than 6 weeks
• Having pain intensity over 3 according to VAS

You may not qualify if:

• Having cervical radiculopathy
• Having spinal deformities
• Having post-traumatic symptom onset
• Having a history of shoulder dislocation or fracture
• Having passive joint movement limitation (frozen shoulder)
• Having received steroid injections within the last 6 weeks
• Having degenerative joint disease of the shoulder joint complex, having a history of surgical intervention to the shoulder joint complex, having any diagnosed rheumatic, systemic or neurological disease
• Having cardiovascular pathologies that limit rehabilitation

Sponsors & Collaborators

• Ankara Yildirim Beyazıt University: lead

Study Sites (1)

Hitit University

Çorum, 19000, Turkey (Türkiye)

Location

Study Officials

• Zeynel Abidin Çapa, MSc

  Hitit University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Zeynel Abidin Çapa, Msc

CONTACT

+905543789285; fztzacapa@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 21, 2025
• First Posted: June 29, 2025
• Study Start: July 28, 2025
• Primary Completion (Estimated): September 28, 2026
• Study Completion (Estimated): September 28, 2026
• Last Updated: June 29, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)