Mobilization With Movement in Rotator Cuff Tendinopathy

NCT07656441 | Not Yet Recruiting

• 1 other identifier: KAEÜFTR
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

This randomized controlled trial aims to investigate the effects of Mobilization With Movement (MWM) combined with exercise therapy on tendon morphology, pain, and functional outcomes in individuals with rotator cuff tendinopathy. A total of approximately 60 participants diagnosed with supraspinatus tendinopathy will be randomly assigned to either an exercise-only group or an exercise plus MWM group. All participants will undergo a standardized rehabilitation program for 8 weeks. Clinical outcomes, including pain intensity (Visual Analog Scale), shoulder function (SPADI and QuickDASH), range of motion, muscle strength, proprioception, and psychosocial status (Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale, and Central Sensitization Inventory), will be assessed at baseline and post-intervention. In addition, ultrasound imaging will be used to evaluate tendon morphology, including tendon thickness, subacromial bursa thickness, acromiohumeral distance, echogenicity, and vascularity. The primary objective is to determine whether MWM produces superior improvements in clinical outcomes and whether it is associated with measurable changes in tendon structure as assessed by ultrasound. The findings are expected to contribute to a better understanding of the biomechanical and neurophysiological mechanisms underlying manual therapy in rotator cuff tendinopathy and to provide evidence for its role in musculoskeletal rehabilitation.

Conditions

Rotator Cuff Syndrome

Outcome Measures

Primary Outcomes (1)

• Supraspinatus Tendon Thickness

  Supraspinatus tendon thickness will be measured using musculoskeletal ultrasound imaging. Measurements will be obtained at the tendon footprint in the longitudinal plane using a high-frequency linear transducer. Tendon thickness will be recorded in millimeters (mm). This variable is selected as the primary structural outcome to evaluate morphological changes associated with the intervention. Increased or decreased tendon thickness will be interpreted in relation to clinical improvement and tissue remodeling.

  Baseline (Week 0) and post-intervention (Week 8)

Secondary Outcomes (9)

• Pain Intensity

  Baseline (Week 0) and post-intervention (Week 8)

• Shoulder Pain and Disability Index (SPADI)

  Baseline (Week 0) and post-intervention (Week 8)

• QuickDASH Score

  Baseline (Week 0) and post-intervention (Week 8)

• Shoulder Range of Motion (ROM)

  Baseline (Week 0) and post-intervention (Week 8)

• Shoulder Muscle Strength

  Baseline (Week 0) and post-intervention (Week 8)

Study Arms (2)

Exercise Only Group

ACTIVE COMPARATOR

Participants will receive a standardized shoulder exercise program focusing on rotator cuff strengthening, scapular stabilization, stretching, and range of motion exercises.

Behavioral: Exercise Therapy

Exercise + Mobilization With Movement (MWM) Group

EXPERIMENTAL

Participants will receive the same standardized exercise program in addition to glenohumeral joint Mobilization With Movement (MWM) techniques.

Behavioral: Exercise Therapy; Procedure: Mobilization With Movement (MWM)

Interventions

Exercise Therapy BEHAVIORAL

A standardized physiotherapy program including rotator cuff strengthening exercises, scapular stabilization exercises, posterior capsule stretching, pectoralis minor stretching, and active range of motion exercises for the shoulder.3 sessions per week for 8 weeks (supervised and/or home-based depending on protocol design)

Exercise + Mobilization With Movement (MWM) Group; Exercise Only Group

Mobilization With Movement (MWM) PROCEDURE

Glenohumeral joint Mobilization With Movement techniques (Mulligan concept), including posterior glide and inferior glide techniques applied during active shoulder movement, aimed at improving pain-free range of motion and function. Application Details: Grade: Sustained glide during active movement Techniques: Posterior glide, inferior glide Dosage: 2 sessions per week for 8 weeks Performed by licensed physiotherapist

Exercise + Mobilization With Movement (MWM) Group

Eligibility Criteria

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

You may qualify if:

• Age between 18 and 65 years
• Clinical diagnosis of rotator cuff tendinopathy (supraspinatus involvement) confirmed by musculoskeletal ultrasound
• Shoulder pain duration of at least 3 months
• Pain intensity ≥ 3/10 on the Visual Analog Scale (VAS)
• Ability to understand and follow instructions and complete questionnaires

You may not qualify if:

• Full-thickness or large rotator cuff tear confirmed by ultrasound or MRI
• History of shoulder surgery on the affected side
• Diagnosis of adhesive capsulitis (frozen shoulder)
• Shoulder instability or dislocation history
• Cervical radiculopathy or referred neck-related shoulder pain
• Inflammatory rheumatic diseases (e.g., rheumatoid arthritis, ankylosing spondylitis)
• Neurological disorders affecting upper extremity function
• Corticosteroid injection in the shoulder within the last 6 months
• Ongoing physiotherapy or manual therapy treatment for shoulder pain in the last 3 months
• Severe systemic or psychiatric conditions that may interfere with participation

Sponsors & Collaborators

• Kirsehir Ahi Evran Universitesi: lead

MeSH Terms

Interventions

Exercise Therapy; Movement

Intervention Hierarchy (Ancestors)

Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Physiological Phenomena; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Ömer ÖZÇELEP, Assist. Prof.

  Kirsehir Ahi Evran Universitesi

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Due to the nature of the interventions, participants and care providers cannot be blinded to group allocation. However, outcome assessments will be performed by an independent assessor who is blinded to group assignment. The assessor will not be involved in the treatment process or randomization procedures. This single-blind design is used to minimize assessment bias in both clinical and ultrasound-based outcome measures.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assist. Prof.

Model Details: This study is designed as a two-arm, parallel-group, randomized controlled interventional trial. Participants diagnosed with rotator cuff tendinopathy will be randomly allocated into either an exercise-only group or an exercise plus Mobilization With Movement (MWM) group. The intervention will be delivered over an 8-week period, and both groups will receive standardized exercise therapy. The experimental group will additionally receive MWM techniques applied to the glenohumeral joint. Outcomes will be assessed at baseline and immediately after the intervention period. The study follows a superiority framework, aiming to determine whether the addition of MWM provides greater improvements in tendon morphology (as assessed by ultrasound imaging), pain intensity, shoulder function, range of motion, muscle strength, proprioception, and psychosocial variables compared to exercise therapy alone. Randomization will be performed using a computer-generated sequence, and outcome assessors will

Study Record Dates

• First Submitted: June 15, 2026
• First Posted: June 18, 2026
• Study Start: July 8, 2026
• Primary Completion (Estimated): December 12, 2026
• Study Completion (Estimated): December 13, 2026
• Last Updated: June 18, 2026

Record last verified: 2026-06