Effect of PRP With Physiotherapy on Shoulder Impingement

NCT07410208 | Completed

• 1 other identifier: Decision number 12
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

Background Shoulder impingement syndrome is the most common disorder of the shoulder. Study results on the effectiveness of treatment options are inconclusive and limited. Therefore, more evidence is needed for long-term results Objective To investigate the effectiveness of the ideal physiotherapy protocol (IPRP-PT) applied after platelet-rich plasma (PRP) injection on pain and functionality in patients with shoulder impingement syndrome, and to propose an alternative treatment protocol. Methods The study was performed in 54 patients with shoulder impingement syndrome who were injected with PRP. Patients were randomly divided into two equal groups. For 21 days, the study group received IPRP-PT study protocol, conventional physiotherapy and home exercise programme, while the control group received only conventional physiotherapy programme. Normal range of motion, muscle strength and posture were assessed. In addition, short form Mc-gill (SF-MPQ), Visual Analogue Scale (VAS), Constant Murley Shoulder Score, Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA), were used.

Conditions

Functionality; Shoulder Impingement Syndrome; Platelet-Rich Plasma

Keywords

Shoulder Impingement Syndrome; Platelet-Rich Plasma; Exercise; Pain; Functionality

Outcome Measures

Primary Outcomes (3)

• Posture Assessment

  Corbin posture scale was used. Postural scores obtained by looking laterally and posteriorly were summed and evaluated as (0-2: excellent, 3-4: very good, 5-7: good, 8-11: fair, 12≥ poor).

  Baseline and Day 21

• Range of Motion (ROM) Evaluation

  Normal joint movements were assessed using a universal goniometer. Passive and active shoulder joint flexion, extension, abduction, internal rotation, and external rotation were evaluated.

  Baseline and Day 21

• Manual Muscle Test

  During the manual muscle test, the patient was positioned appropriately for the muscle being evaluated. They were asked to actively perform the movement. The force generated by the muscle was evaluated by applying manual resistance. Muscle strength of the shoulder flexors, extensors, abductors, internal rotators, and external rotators was rated on a scale of 0-5 (no contraction 0, very weak 1, weak 2, moderate 3, good 4, and normal 5.

  Baseline and Day 21

Secondary Outcomes (4)

• Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH)

  Baseline and Day 21

• Constant Murley Shoulder Score (CMS)

  Baseline and Day 21

• Pain Assessment

  Baseline and Day 21

• Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA)

  Baseline and Day 21

Study Arms (2)

Study group

EXPERIMENTAL

Drug: Platelet Rich Plasma (PRP); Other: Conventional physiotherapy programme; Other: IPRP-PT Study Protocol

Control Group

ACTIVE COMPARATOR

Drug: Platelet Rich Plasma (PRP); Other: Conventional physiotherapy programme

Interventions

Conventional physiotherapy programme OTHER

It was applied once a day for 21 days to 54 patients included in the study. Ultrasound; Enraf Nonius Sonopuls692V® device was applied around the glenohumeral joint with an average treatment dose of 3 MHz, N 1.5 w/cm² and 8 minutes. Transcutaneous Electrical Nerve Stimulation (TENS); Enraf Nonius Sonopuls 692V® device was applied to the glenohumeral joint with a frequency between 60-120 Hz and a transition time of 50-100 µsec for 20 min. Hot Pack; It was applied to the glenohumeral joint for 20 minutes (Kuhn, 2009; Kul and Ugur, 2019; Walsh, Howe, Johnson, and Sluka, 2009).

Control Group; Study group

Platelet Rich Plasma (PRP) DRUG

All patients included in the study were educated about the correct posture in daily life, sleeping position, and the things to be followed to improve the quality of life. In addition to 2 cc anticoagulant citrate dextrose withdrawn syringe, 20 cc of blood was taken by the nurse from the patients diagnosed with shoulder impingement syndrome. After the blood was transferred to a special PRP kit and centrifuged at 4000 rpm for 8-9 minutes, the platelet-rich plasma portion remaining at the top of the kit was taken into the syringe and applied to the 1/3 posterolateral 1/3 of the glenohumeral joint by the physician. After PRP injections, evaluations of the study and control groups were performed before and after 21 days of treatment. The study group received IPRP-PT study protocol, conventional physiotherapy and home exercises, while the control group received only conventional physiotherapy and home programme.

Control Group; Study group

IPRP-PT Study Protocol OTHER

IPRP-PT study protocol was applied in addition to conventional physiotherapy for 21 days in 27 patients who underwent PRP injection in our study group. The exercises were performed once a day with a physiotherapist and twice a day at home. The exercises performed were as follows; posterior capsule stretching; wand exercise; scapulatoracic (st), acromioclavicular (ac) and sternoclavicular (sc) joint mobilisation; GH joint posterior, anterior, inferior sliding; GH joint distraction; deep friction massage of the tendon of the supraspinatus muscle; kinesiological taping; isometric and isotonic strengthening exercises; proprioceptive neuromuscular facilitation exercises (pnf); closed kinetic ring and proprioception exercises

Study group

Eligibility Criteria

• Age: 30 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age between 30-65 years
• Diagnosis of stage I or II shoulder impingement syndrome
• Received one dose of PRP injection
• Referred for and seeking physical therapy
• Voluntary participation
• Ability to cooperate with the study procedures

You may not qualify if:

• Previous surgical treatment for shoulder impingement syndrome
• Presence of other orthopedic conditions (e.g., shoulder fractures)
• Presence of neuromuscular disease
• Presence of a pacemaker
• Pregnancy

Sponsors & Collaborators

• Istinye University: lead

Study Sites (1)

İstinye Üniversitesi

Istanbul, Merkez, 08100, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Shoulder Impingement Syndrome; Motor Activity; Pain

Condition Hierarchy (Ancestors)

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

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer

Study Record Dates

• First Submitted: January 21, 2026
• First Posted: February 13, 2026
• Study Start: July 15, 2019
• Primary Completion: March 20, 2020
• Study Completion: July 30, 2020
• Last Updated: April 13, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)