Prone Row Exercise Versus Lateral Pull Down Exercise In Shoulder Impingement Syndrome With Scapular Dyskinesia

NCT07577791 | Not Yet Recruiting DMC

• 1 other identifier: P.T.REC/012/006445
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to compare the prone row exercise, and the lateral pull down exercise, in individuals diagnosed with shoulder impingement syndrome and scapular dyskinesia regarding latissimus dorsi strength, middle trapezius strength, lower trapezius strength, rhomboids strength, Visual analog scale score, Shoulder pain and disability index score and scapular stability test values.

Conditions

Scapular Dyskinesis; Shoulder Impingement Syndrome

Keywords

shoulder impingement syndrome; scapular dyskinesia

Outcome Measures

Primary Outcomes (4)

• Lateral scapular slide test

  Lateral Scapular Slide Test (LSST), defined as a side-to-side scapular difference of 1.5 cm or more in any of the three arm positions, indicating scapular asymmetry associated with dyskinesis (Odom, 2001; Kibler, 1998).

  (pre-intervention) and after 6 weeks (post-intervention)

• Isometric muscle strength testing of latissimus dorsi, middle trapezius, lower trapezius and rhomboids muscles using Handheld dynamometer (HHD)

  Lafayette HHD revealed mostly good to excellent reliability (coefficients ≥ 0.70) for all LL muscles measurements. Also, it has good validity for most measures of isometric LL strength and power in healthy population. Lafayette HHD is a reliable instrument to measure the foot and ankle strength of young and older adults, for both intra-rater (ICC (3,1) = 0.78-0.94) and interrater (ICC (3,1) = 0.77-0.88) comparisons. (Celik et al., 2012).

  (pre-intervention) and after 6 weeks (post-intervention)

• Pain using the Visual Analogue Scale (VAS)

  The Visual Analogue Scale (VAS) will be used to measure pain. The VAS is a straight line, with one end representing 0 (no pain) and the other end representing 10 (worst pain possible). The number 0 indicates no problem, and 10 represents the worst possible condition (Huskisson, 1974).

  (pre-intervention) and after 6 weeks (post-intervention)

• Function using SPADI

  Shoulder pain and disability index (SPADI) is demonstrated to be a validated and reliable measure of shoulder pain and disability (Roach et al., 1991). The translated version of SPADI in the Arabic language showed excellent internal consistency and test-retest reliability and construct validity based on substantial correlations of Arabic SPADI with Quick DASH, NRS, and active shoulder ROM. SPADI is recommended for the evaluation of patients with shoulder dysfunction (Alsanawi et al.,2015)

  (pre-intervention) and after 6 weeks (post-intervention)

Study Arms (2)

Group A: Prone Row exercise and selected physical therapy program group

EXPERIMENTAL

Prone rowing and selected physical therapy treatment, which includes stretches to pectoralis minor, Posterior soft tissue. Codman's exercise, scapular sets and Wall slides and Postural exercises like thoracic extensions, Chin tuck and Scapular retraction exercises (Dabholkar \& Yardi 2015).

Procedure: Group A will perform the prone row exercise and selected physical therapy treatment

Group B:the Lateral Pull Down exercise and selected physical therapy program received by Group A

EXPERIMENTAL

Lateral Pull Down exercise and selected physical therapy treatment, which includes stretches to pectoralis minor, Posterior soft tissue. Codman's exercise, scapular sets and Wall slides and Postural exercises like thoracic extensions, Chin tuck and Scapular retraction exercises

Procedure: Group B will receive selected physical therapy treatment and Lateral pull down exercise.

Interventions

Group A will perform the prone row exercise and selected physical therapy treatment PROCEDURE

prone row exercise: freely off the side and the head in a neutral position, supported if needed. The starting position involves 90-degree shoulder flexion with full elbow extension (0-degree elbow flexion), transitioning into 0-degree shoulder flexion with 90-degree elbow flexion. From this position, a bilateral vertical pulling movement is performed, involving scapular retraction and shoulder extension against resistance. The motion ends with the elbow flexed at 90 degrees, the shoulder extended, and the scapula fully retracted towards the spine, with control throughout the movement. selected physical therapy treatment, which includes stretches to pectoralis minor, Posterior soft tissue. Codman's exercise, scapular sets and Wall slides and Postural exercises like thoracic extensions, Chin tuck and Scapular retraction exercises

Group A: Prone Row exercise and selected physical therapy program group

Group B will receive selected physical therapy treatment and Lateral pull down exercise. PROCEDURE

The patient is seated on the pulldown machine with an upright trunk and feet flat on the floor, maintaining a stable posture. The starting position includes gripping the straight bar with a wide overhand (pronated) grip, marked to ensure a between-hands distance equal to 1.6 times the biacromial distance which is the horizontal distance between the most lateral points of the right and left acromion processes (shoulder tip). From this position, the participant performs a downward pulling movement, bringing the bar down in front of the face toward the upper chest near the clavicle in a smooth and controlled manner. selected physical therapy treatment, which includes stretches to pectoralis minor, Posterior soft tissue. Codman's exercise, scapular sets and Wall slides and Postural exercises like thoracic extensions, Chin tuck and Scapular retraction exercises

Group B:the Lateral Pull Down exercise and selected physical therapy program received by Group A

Eligibility Criteria

• Age: 40 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Fifty-four male and female.
• Individuals diagnosed with SIS and aged between 40-65 years with right-hand dominance (Andrea et al., 2024).
• Participants experiencing shoulder pain persisting for a minimum duration of 3 months (Lucas et al., 2022).
• Subjects with a primary complaint of shoulder impingement and scapular dyskinesia according to Neer's classification specifically in stages I and II are referred by an orthopedist (El Melhat et al., 2025).
• Body mass index (BMI) is ≥ 25 kg/m² (Maryam et al., 2023).
• Individuals with a positive Lateral Scapular Slide Test (LSST), defined as a side-to-side scapular difference of 1.5 cm or more in any of the three arm positions, indicating scapular asymmetry associated with dyskinesis (Kibler, 2003; Odom, 2001).
• All participants must have the cognitive ability to understand instructions and provide informed consent, consistent with standards highlighted in recent informed consent meta-analyses (Tam et al., 2015).

You may not qualify if:

• History of shoulder surgery, dislocation, or fracture (Crawshaw et al., 2010).
• History of neurological disorders (Crawshaw et al., 2010).
• Participants will be excluded if they had cervical spine pain or any signs of cervical radiculopathy (Magee, 2014).
• Individuals with chronic low back pain will be also excluded (Mohamed et al., 2022).
• Pregnant women will be excluded from participation in this study.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of Physical Therapy, Cairo University

Cairo, Egypt

Location

Related Publications (17)

• Yilmaz Gokmen G, Akcay B, Kecelioglu S, Ozen MS, Yuce H. Physical and well-being effect of scapular kinesio taping combined with conventional physiotherapy in shoulder impingement syndrome: A randomized controlled study. J Back Musculoskelet Rehabil. 2023;36(6):1375-1383. doi: 10.3233/BMR-220396.

  PMID: 37694348 BACKGROUND

• Ronai, P. (2017). The barbell row exercise. ACSM's Health & Fitness Journal, 21(2), 25-28.

  BACKGROUND

• Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991 Dec;4(4):143-9.

  PMID: 11188601 BACKGROUND

• Obikili, E. N. (2006). Biacromial and Biiliac Diameters in a Young Adult Southeastern Nigerian Population. Journal of Experimental and Clinical Anatomy, 5(1), 22-25.

  BACKGROUND

• Odom CJ, Taylor AB, Hurd CE, Denegar CR. Measurement of scapular asymetry and assessment of shoulder dysfunction using the Lateral Scapular Slide Test: a reliability and validity study. Phys Ther. 2001 Feb;81(2):799-809. doi: 10.1093/ptj/81.2.799.

  PMID: 11235656 BACKGROUND

• Noguchi M, Chopp JN, Borgs SP, Dickerson CR. Scapular orientation following repetitive prone rowing: implications for potential subacromial impingement mechanisms. J Electromyogr Kinesiol. 2013 Dec;23(6):1356-61. doi: 10.1016/j.jelekin.2013.08.007. Epub 2013 Aug 31.

  PMID: 24055533 BACKGROUND

• McClure PW, Bialker J, Neff N, Williams G, Karduna A. Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program. Phys Ther. 2004 Sep;84(9):832-48.

  PMID: 15330696 BACKGROUND

• Lehman GJ, Buchan DD, Lundy A, Myers N, Nalborczyk A. Variations in muscle activation levels during traditional latissimus dorsi weight training exercises: An experimental study. Dyn Med. 2004 Jun 30;3(1):4. doi: 10.1186/1476-5918-3-4.

  PMID: 15228624 BACKGROUND

• Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med. 1998 Mar-Apr;26(2):325-37. doi: 10.1177/03635465980260022801.

  PMID: 9548131 BACKGROUND

• Huskisson EC. Measurement of pain. Lancet. 1974 Nov 9;2(7889):1127-31. doi: 10.1016/s0140-6736(74)90884-8. No abstract available.

  PMID: 4139420 BACKGROUND

• Helgadottir H, Kristjansson E, Einarsson E, Karduna A, Jonsson H Jr. Altered activity of the serratus anterior during unilateral arm elevation in patients with cervical disorders. J Electromyogr Kinesiol. 2011 Dec;21(6):947-53. doi: 10.1016/j.jelekin.2011.07.007. Epub 2011 Sep 1.

  PMID: 21889362 BACKGROUND

• Fischer J, Burger C, Seguel JM, Rodoplu C, Paternoster FK, Tilp M, Konrad A. Impact of different ranges of motion in the prone barbell row on muscle excitation. J Electromyogr Kinesiol. 2025 Aug;83:103025. doi: 10.1016/j.jelekin.2025.103025. Epub 2025 Jun 9.

  PMID: 40513198 BACKGROUND

• Dabholkar Ajit, S., & Yardi Sujata, S. (2015). Effects of scapular muscle strengthening on shoulder function and disability in shoulder impingement syndrome (SIS)-A randomized controlled trial

  BACKGROUND

• Cools, A. M., Dewitte, V., Lanszweert, F., Notebaert, D., Roets, A., Soetens, B., & Witvrouw, E. (2007). Scapular muscle rehabilitation exercises in overhead athletes with impingement symptoms: Effect of a 6-week training program on scapular muscle recruitment and functional outcome. British Journal of Sports Medicine, 41(11), 818-824

  BACKGROUND

• Celik D, Dirican A, Baltaci G. Intrarater reliability of assessing strength of the shoulder and scapular muscles. J Sport Rehabil. 2012 Feb 29;21(1):1-5. doi: 10.1123/jsr.2012.TR3. Print 2012 Feb 1.

  PMID: 22495260 BACKGROUND

• Alsanawi HA, Alghadir A, Anwer S, Roach KE, Alawaji A. Cross-cultural adaptation and psychometric properties of an Arabic version of the Shoulder Pain and Disability Index. Int J Rehabil Res. 2015 Sep;38(3):270-5. doi: 10.1097/MRR.0000000000000118.

  PMID: 25954858 BACKGROUND

• Baskurt Z, Baskurt F, Gelecek N, Ozkan MH. The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome. J Back Musculoskelet Rehabil. 2011;24(3):173-9. doi: 10.3233/BMR-2011-0291.

  PMID: 21849731 RESULT

Related Links

• Related Info

MeSH Terms

Conditions

Shoulder Impingement Syndrome

Condition Hierarchy (Ancestors)

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

Central Study Contacts

mennatallah maher, MSc

CONTACT

0201096430623; mennaallah.maher@cu.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: The study will employ a two experimental group protocol. Participants will be randomly allocated into two groups using the lottery method. Folded papers labeled with group codes will be placed in a container and picked at random by an independent person. This simple randomization ensures equal allocation probability and minimizes selection bias.

Study Record Dates

• First Submitted: May 5, 2026
• First Posted: May 11, 2026
• Study Start (Estimated): August 29, 2026
• Primary Completion (Estimated): September 19, 2026
• Study Completion (Estimated): September 30, 2026
• Last Updated: May 13, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)