Percussion Massage Therapy and IASTM in Subacromial Impingement Syndrome

NCT07291843 | Completed

• 1 other identifier: E-10840098-202.3.02-7891
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

This assessor-blinded, three-arm, parallel-group randomized controlled trial investigated the additional effects of percussion massage therapy and instrument-assisted soft tissue mobilization in individuals with subacromial impingement syndrome. Forty-eight participants aged 40-60 years with clinically and magnetic resonance imaging-confirmed subacromial impingement syndrome were randomly allocated in a 1:1:1 ratio to conventional physiotherapy, percussion massage therapy plus conventional physiotherapy, or instrument-assisted soft tissue mobilization plus conventional physiotherapy. All groups received a standardized four-week conventional physiotherapy programme. Participants in the percussion massage therapy and instrument-assisted soft tissue mobilization groups additionally received their respective interventions three times per week for four weeks. Outcomes were evaluated at baseline and immediately after the four-week intervention. The primary outcome was shoulder joint position sense during flexion and abduction. Secondary outcomes were shoulder range of motion, resting and activity-related pain, upper-extremity disability, and rotator cuff-related quality of life.

Conditions

Impingement Syndrome; Impingement Shoulder; Shoulder Pain

Keywords

Subacromial Impingement Syndrome; Shoulder Pain; Instrument-Assisted Soft Tissue Mobilization (IASTM); Percussion Massage Therapy; Physiotherapy

Outcome Measures

Primary Outcomes (1)

• Change in Shoulder Joint Position Sense Error

  Shoulder joint position sense was assessed using a digital goniometer at target positions of 60 degrees of shoulder flexion and 60 degrees of shoulder abduction. The affected shoulder was passively positioned at the target angle, and the participant was allowed up to 10 seconds to memorize the position. The arm was then returned to the neutral position, and the participant was asked to actively reproduce the target position with the eyes closed. The absolute angular difference between the target position and the reproduced position was calculated in degrees. Three trials were conducted for flexion and three trials for abduction, and the mean absolute error for each direction was used in the analysis. Lower values indicate greater joint position sense accuracy.

  Baseline and immediately after the 4-week intervention

Secondary Outcomes (4)

• Change in Shoulder Range of Motion

  Baseline and immediately after the 4-week intervention

• Change in Resting and Activity-Related Shoulder Pain

  Baseline and immediately after the 4-week intervention

• Change in Upper-Extremity Disability

  Baseline and immediately after the 4-week intervention

• Change in Rotator Cuff-Related Quality of Life

  Baseline and immediately after the 4-week intervention

Study Arms (3)

Percussion Massage Therapy Plus Conventional Physiotherapy

EXPERIMENTAL

Participants received the standardized conventional physiotherapy programme for four weeks and additionally received percussion massage therapy three times per week for four weeks.

Device: Percussion massage therapy device; Other: Conventional Physiotherapy

IASTM Plus Conventional Physiotherapy

EXPERIMENTAL

Participants received the standardized conventional physiotherapy programme for four weeks and additionally received instrument-assisted soft tissue mobilization three times per week for four weeks.

Device: Instrument-assisted soft tissue mobilization device; Other: Conventional Physiotherapy

Conventional Physiotherapy

ACTIVE COMPARATOR

Participants received a standardized, supervised conventional physiotherapy programme five sessions per week for four weeks.

Other: Conventional Physiotherapy

Interventions

Instrument-assisted soft tissue mobilization device DEVICE

Instrument-assisted soft tissue mobilization was administered to the deltoid, supraspinatus, infraspinatus, and teres minor muscles three times per week for four weeks. All applications were performed by the same licensed physiotherapist. Standardized sweep and brush stroke techniques were applied at an approximate treatment angle of 45 degrees and in accordance with the anatomical fibre orientation of each muscle. For each muscle, 20 seconds of parallel strokes were followed by 20 seconds of perpendicular strokes using controlled sweeping movements. The intervention was provided in addition to the conventional physiotherapy programme.

Also known as: IASTM

IASTM Plus Conventional Physiotherapy

Percussion massage therapy device DEVICE

Percussion massage therapy was administered using a handheld Hypervolt device (Hyperice, California, USA) at 33 Hz, corresponding to level 2 of the device. A flat-head attachment was used to provide uniform contact with the treated tissues. The intervention was applied to the deltoid, supraspinatus, infraspinatus, and teres minor muscles along their anatomical fibre orientation. Each muscle was treated for three minutes using controlled longitudinal strokes applied alternately in proximal-to-distal and distal-to-proximal directions. The intervention was administered by the same licensed physiotherapist three times per week for four weeks, concurrently with the conventional physiotherapy programme.

Also known as: Hypervolt Percussion Massage Device

Percussion Massage Therapy Plus Conventional Physiotherapy

Conventional Physiotherapy OTHER

Participants received a standardized, supervised conventional physiotherapy programme for four weeks, administered five sessions per week by a licensed physiotherapist. Each session included transcutaneous electrical nerve stimulation applied to the symptomatic shoulder for 20 minutes at 100 Hz, followed by a structured exercise programme. The exercise programme included wand-assisted active range-of-motion exercises for shoulder flexion, abduction, extension, internal rotation, and external rotation; Codman pendulum exercises; active and passive stretching; and finger ladder exercises. Progressive strengthening exercises using elastic resistance bands were performed for shoulder flexion, abduction, internal rotation, external rotation, and extension. Resistance was progressively adjusted according to pain severity, functional capacity, and treatment tolerance, while a standardized volume of 10 repetitions per set was maintained.

Conventional Physiotherapy; IASTM Plus Conventional Physiotherapy; Percussion Massage Therapy Plus Conventional Physiotherapy

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Men or women aged 40 to 60 years.
• Diagnosis of subacromial impingement syndrome confirmed by clinical examination and -magnetic resonance imaging.
• Positive Neer test.
• Positive Hawkins-Kennedy test.
• Positive painful arc test.
• Shoulder symptoms persisting for at least one month.
• Ability and willingness to participate in the assessment and intervention programme.
• Provision of written informed consent.

You may not qualify if:

• Previous surgery involving the affected upper extremity.
• Inflammatory joint disease.
• Shoulder osteoarthritis.
• Rheumatic disease.
• Malignant or benign tumour affecting the shoulder region or upper extremity.
• Open wound or active infection in the shoulder region.
• Inability to tolerate vibration-based therapy.
• Inability to comply with the study protocol or intervention programme.

Sponsors & Collaborators

• Emre DANSUK: lead

Study Sites (1)

Emre Dansuk

Istanbul, Beykoz, 34815, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Shoulder Impingement Syndrome; Shoulder Pain

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries; Arthralgia; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Emre Dansuk, PhD

  Medipol University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Because of the nature of the interventions, participants and treating physiotherapists were aware of the allocated intervention. Outcome assessments were conducted by an independent physiotherapist who was blinded to group allocation. Statistical analyses were performed by a biostatistician blinded to coded group assignments.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Participants were randomly allocated in a 1:1:1 ratio to conventional physiotherapy, percussion massage therapy plus conventional physiotherapy, or instrument-assisted soft tissue mobilization plus conventional physiotherapy. Each participant remained in the assigned parallel intervention group throughout the four-week study period.

Study Record Dates

• First Submitted: December 6, 2025
• First Posted: December 18, 2025
• Study Start: December 10, 2025
• Primary Completion: February 1, 2026
• Study Completion: February 15, 2026
• Last Updated: July 24, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: Beginning immediately after publication and available for five years.

Locations

TU (1)