Effects of Dry Needling in Athletes With Subacromial Pain Syndrome

NCT07621016 | Not Yet Recruiting

• 1 other identifier: SDSA-PS-2026
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to evaluate whether dry needling combined with therapeutic exercise improves shoulder proprioception in amateur athletes with subacromial pain syndrome. The study will also assess its effects on dynamic stability, strength, pain, and functional disability. The main questions this study aims to answer are: Does dry needling improve shoulder proprioception compared with therapeutic exercise alone? Does dry needling improve dynamic shoulder stability and muscle strength? Does dry needling reduce pain and upper limb disability? Researchers will compare a group receiving dry needling plus therapeutic exercise with a group performing therapeutic exercise alone to determine whether the combined intervention produces better outcomes. Participants will: Be randomly assigned to one of the two treatment groups. Perform a home-based therapeutic exercise program for 3 weeks. Complete assessments of proprioception, dynamic stability, strength, pain, and functional disability before and after the intervention.

Conditions

Subacromial Pain Syndrome

Keywords

subacromial pain syndrome; dry needling; shoulder proprioception; shoulder pain

Outcome Measures

Primary Outcomes (1)

• Shoulder Proprioception Assessed With the Joint Position Sense Test

  Shoulder proprioception will be evaluated using the Joint Position Sense (JPS) test. Participants will actively reproduce a predefined shoulder position (abduction at 60°), and the absolute angular repositioning error in degrees will be recorded using an inclinometer. Scores range from 0 degrees (perfect repositioning) to no defined upper limit, with lower values indicating better proprioceptive accuracy.

  Baseline, 10 days after the first intervention session, and 10 days after the second intervention session

Secondary Outcomes (4)

• Dynamic Shoulder Stability Assessed With the Upper Quarter Y Balance Test

  Baseline, 10 days after the first intervention session, and 10 days after the second intervention session

• Isometric Shoulder Strength Assessed With Handheld Dynamometry

  Baseline, 10 days after the first intervention session, and 10 days after the second intervention session

• Pain Intensity Assessed With the Numeric Rating Scale

  Baseline, 10 days after the first intervention session, and 10 days after the second intervention session

• Upper Limb Disability Assessed With the Disabilities of the Arm, Shoulder and Hand Questionnaire

  Baseline, 10 days after the first intervention session, and 10 days after the second intervention session

Study Arms (2)

Dry needling + therapeutic exercise

EXPERIMENTAL

Participants assigned to the experimental group will receive a combined intervention consisting of dry needling and a structured home-based therapeutic exercise program over a 3-week period. Dry needling will be applied to active myofascial trigger points in scapulohumeral muscles commonly associated with subacromial pain syndrome, including the supraspinatus, infraspinatus, subscapularis, teres minor, teres major, and anterior and middle deltoid muscles. Trigger points will be identified through standardized clinical examination based on the presence of a palpable taut band, a hypersensitive spot, reproduction of recognizable pain, and local twitch response. The intervention will be performed by a physiotherapist with more than 10 years of experience and certified training in dry needling, using a fast in-fast out technique with sterile disposable needles after skin disinfection with chlorhexidine.

Procedure: Dry needling; Behavioral: Therapeutic Exercise

Therapeutic exercise

ACTIVE COMPARATOR

Participants assigned to the control group will receive a structured home-based therapeutic exercise program over a 3-week period without dry needling intervention. The exercise program will focus on shoulder strengthening, neuromuscular control, and sensorimotor function using elastic resistance bands. Participants will perform the exercises three times per week for 3 weeks following a standardized protocol. All participants will receive individualized in-person instruction from a physiotherapist to ensure correct exercise execution. Participants will also receive the necessary exercise materials and an adherence diary to record compliance throughout the intervention period. The therapeutic exercise program will be identical to the experimental group in terms of exercise type, frequency, duration, supervision, and home-based format.

Behavioral: Therapeutic Exercise

Interventions

Dry needling PROCEDURE

Dry needling will be applied to active myofascial trigger points identified in scapulohumeral muscles commonly associated with subacromial pain syndrome, including supraspinatus, infraspinatus, subscapularis, teres minor, teres major, and anterior and middle deltoid muscles. Trigger points will be identified through standardized clinical examination. The intervention will be performed by an experienced physiotherapist using sterile disposable needles and a standardized fast in-fast out technique. Participants will receive two dry needling sessions separated by a 10-day interval.

Dry needling + therapeutic exercise

Therapeutic Exercise BEHAVIORAL

Participants will perform a structured home-based therapeutic exercise program focused on shoulder strengthening, neuromuscular control, and sensorimotor function using elastic resistance bands. The exercise program will be performed three times per week for 3 weeks following a standardized protocol. Participants will receive individualized instruction, exercise materials, and adherence monitoring throughout the intervention period.

Dry needling + therapeutic exercise; Therapeutic exercise

Eligibility Criteria

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

You may qualify if:

• Men and women aged between 18 and 40 years.
• Clinical diagnosis of subacromial pain syndrome (SAPS) according to the Dutch Orthopaedic Association criteria: presence of a painful arc and at least two positive tests among the following: Hawkins-Kennedy test, Neer sign, Jobe test, Drop Arm test, or Gerber test.
• Participation in sports involving predominant upper-limb activity between 2 and 4 hours per week.

You may not qualify if:

• Previous surgery involving the upper extremities.
• Diagnosis of specific shoulder pathologies other than SAPS at the time of the study.
• Receipt of medical or physiotherapy treatment within the month prior to the intervention.
• Needle phobia or refusal to receive dry needling treatment.
• Presence of vestibular disorders, balance impairments, or vascular alterations that could interfere with study measurements.
• Confirmed or suspected pregnancy.

Sponsors & Collaborators

• Universidad Europea de Valencia: lead

Study Sites (1)

Clínica Dr Villarón

Valencia, Valencia, 46006, Spain

Location

Related Publications (8)

• Chys M, De Meulemeester K, De Greef I, Murillo C, Kindt W, Kouzouz Y, Lescroart B, Cagnie B. Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain-An Umbrella Review. J Clin Med. 2023 Feb 2;12(3):1205. doi: 10.3390/jcm12031205.

  PMID: 36769852 BACKGROUND

• Arias-Buria JL, Fernandez-de-Las-Penas C, Palacios-Cena M, Koppenhaver SL, Salom-Moreno J. Exercises and Dry Needling for Subacromial Pain Syndrome: A Randomized Parallel-Group Trial. J Pain. 2017 Jan;18(1):11-18. doi: 10.1016/j.jpain.2016.08.013. Epub 2016 Oct 5.

  PMID: 27720812 BACKGROUND

• Salom-Moreno J, Ayuso-Casado B, Tamaral-Costa B, Sanchez-Mila Z, Fernandez-de-Las-Penas C, Alburquerque-Sendin F. Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial. Evid Based Complement Alternat Med. 2015;2015:790209. doi: 10.1155/2015/790209. Epub 2015 Apr 30.

  PMID: 26064172 BACKGROUND

• Gliga AC, Neagu NE, Voidazan S, Popoviciu HV, Bataga T. Effects of a Novel Proprioceptive Rehabilitation Device on Shoulder Joint Position Sense, Pain and Function. Medicina (Kaunas). 2022 Sep 9;58(9):1248. doi: 10.3390/medicina58091248.

  PMID: 36143925 BACKGROUND

• Ager AL, Borms D, Deschepper L, Dhooghe R, Dijkhuis J, Roy JS, Cools A. Proprioception: How is it affected by shoulder pain? A systematic review. J Hand Ther. 2020 Oct-Dec;33(4):507-516. doi: 10.1016/j.jht.2019.06.002. Epub 2019 Aug 31.

  PMID: 31481340 BACKGROUND

• Alfaya FF, Reddy RS, Alkhamis BA, Kandakurti PK, Mukherjee D. Shoulder Proprioception and Its Correlation with Pain Intensity and Functional Disability in Individuals with Subacromial Impingement Syndrome-A Cross-Sectional Study. Diagnostics (Basel). 2023 Jun 17;13(12):2099. doi: 10.3390/diagnostics13122099.

  PMID: 37370994 BACKGROUND

• Blanco-Diaz M, Ruiz-Redondo R, Escobio-Prieto I, De la Fuente-Costa M, Albornoz-Cabello M, Casana J. A Systematic Review of the Effectiveness of Dry Needling in Subacromial Syndrome. Biology (Basel). 2022 Feb 4;11(2):243. doi: 10.3390/biology11020243.

  PMID: 35205109 BACKGROUND

• Para-Garcia G, Garcia-Munoz AM, Lopez-Gil JF, Ruiz-Cardenas JD, Garcia-Guillen AI, Lopez-Roman FJ, Perez-Pinero S, Abellan-Ruiz MS, Canovas F, Victoria-Montesinos D. Dry Needling Alone or in Combination with Exercise Therapy versus Other Interventions for Reducing Pain and Disability in Subacromial Pain Syndrome: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022 Sep 2;19(17):10961. doi: 10.3390/ijerph191710961.

  PMID: 36078676 BACKGROUND

MeSH Terms

Conditions

Shoulder Pain

Interventions

Dry Needling; Exercise Therapy

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care

Study Officials

• Carlos A Villaron Casales, PT, MSc, PhD

  Universidad Europea de Valencia

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Pablo Taberner Mortes, PT, MSc

CONTACT

+34 680869335; pablo.taberner@universidadeuropea.es

Alejandro Sendín Magdalena, PT, MSc, PhD

CONTACT

+34 652 53 43 10; alejandro.sendin@universidadeuropea.es

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Outcome assessors and data analysts will remain blinded to group allocation throughout the study. Due to the nature of the intervention, participants and treating physiotherapists cannot be blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor and Researcher

Study Record Dates

• First Submitted: May 27, 2026
• First Posted: June 2, 2026
• Study Start: June 1, 2026
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): March 1, 2027
• Last Updated: June 5, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)