The Combined Effect of Thoracic Manipulation and Instrument-assisted Soft Tissue Mobilization in Patients With Shoulder Impingement Syndrome

NCT07800559 | Not Yet Recruiting

• 1 other identifier: P.T.REC/012/006555
• Study Type: interventional
• Target: 80
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study will be conducted to investigate the combined effect of thoracic manipulation and instrument-assisted soft tissue mobilization in patients with shoulder impingement syndrome

Conditions

Shoulder Impingement Syndrome

Keywords

Thoracic Manipulation; Instrument-assisted Soft Tissue Mobilization; Shoulder Impingement Syndrome

Outcome Measures

Primary Outcomes (1)

• upper limb disability

  Disabilities of the arm, shoulder and hand (Quick DASH) questionnaire will be used toassess upper limb diability.the QuickDASH only contains 11 items .It is a questionnaire that measures an individual's ability to complete tasks, absorb forces, and severity of symptoms.The QuickDASH tool uses a 5-point Likert scale from which the patient can select an appropriate number corresponding to his/her severity/function level.The QuickDASH outcome measure is designed to be used on patients presenting with one or more disabilities of the arm, shoulder, and hand. Scoring with 100 is more severe disability, and zero mean no disability.

  up to six weeks

Secondary Outcomes (5)

• pain intensity

  up to 6 weeks

• shoulder range of motion

  up to six weeks

• shoulder proprioception (joint position error)

  up to six weeks

• life disability

  up to six weeks

• pressure pain threshold

  up to six weeks

Study Arms (4)

conventional physical therapy

ACTIVE COMPARATOR

Twenty patients with shoulder impingement syndrome will receive conventional physical therapy three times per week for 6 weeks

Other: conventional physical therapy

thoracic manibulation

EXPERIMENTAL

twenty patients with shoulder impingement syndrome will receive thoracic manibulation plus conventional physical therapy three times per week for 6 weeks

Other: conventional physical therapy; Other: thoracic manibulation

nstrument assisted soft tissue mobilization

EXPERIMENTAL

twenty patients with shoulder impingement syndrome will receive conventional physical therapy and instrument-assisted soft tissue mobilization three times per week for 6 weeks

Other: conventional physical therapy; Other: instrument assisted soft tissue mobilization

thoracic manipulation and instrument-assisted soft tissue mobilization.

EXPERIMENTAL

twenty patients with shoulder impingement syndrome will receive thoracic manipulation + instrument-assisted soft tissue mobilization. The conventional physical therapy three times per week for 6 weeks

Other: conventional physical therapy; Other: thoracic manibulation; Other: instrument assisted soft tissue mobilization; Other: thoracic manipulation and instrument-assisted soft tissue mobilization

Interventions

conventional physical therapy OTHER

the patients will receive conventional physical therapy in the form of transcutaneous electrical nerve stimulation, ultrasound, and therapeutic exercise. The exercise includes range of motion exercises, stretching, scapular stabilization exercises, and rotator cuff strengthening.

conventional physical therapy; nstrument assisted soft tissue mobilization; thoracic manibulation; thoracic manipulation and instrument-assisted soft tissue mobilization.

thoracic manibulation OTHER

With the participant in a prone position, the therapist will apply a high-velocity, short-lever, posterior-to-anterior (P-A) thrust. The thrust will be directed toward the spinous or transverse processes of the hypomobile thoracic vertebrae. Thoracic thrust manipulation demonstrated to manipulate specific thoracic segment mainly the mid-thoracic, plus conventional physical therapy.

thoracic manibulation; thoracic manipulation and instrument-assisted soft tissue mobilization.

instrument assisted soft tissue mobilization OTHER

The IASTM technique will be performed for 20 seconds parallel to the muscle fibers, followed by 20 seconds perpendicular to the muscle fibers, with the instrument held at a 45° angle to the skin. The beveled side of the M2T blade will be in contact with the skin. Stroke pressure and speed will be modified according to the participant's tolerance to avoid causing pain and according to the depth of the treated muscle plus conventional physical therapy.The technique will be applied to the pectoral muscles, shoulder rotator cuff musculature, and periscapular musculature, including the upper, middle, and lower fibers of the trapezius, rhomboids major and minor, teres major, and latissimus dorsi

nstrument assisted soft tissue mobilization; thoracic manipulation and instrument-assisted soft tissue mobilization.

thoracic manipulation and instrument-assisted soft tissue mobilization OTHER

the patients will receive The IASTM technique will be performed for 20 seconds parallel to the muscle fibers followed by 20 seconds perpendicular to the muscle fibers, with the instrument held at a 45° angle to the skin plus thoracic manibulation in which the therapist will apply a high-velocity, short-lever, posterior-to-anterior (P-A) thrust. The thrust will be directed toward the spinous or transverse processes of the hypomobile thoracic vertebrae. Thoracic thrust manipulation demonstrated to manipulate specific thoracic segments, mainly the mid-thoracic, plus conventional physical therapy. finally, the pateitns will recieve conventional physical therapy

thoracic manipulation and instrument-assisted soft tissue mobilization.

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients with shoulder impingement syndrome from both genders their age from 18-55 years.
• History of shoulder pain for one month.
• Positive Neer's impingement test and Hawkin's Kennedy test.
• Painful arc sign.

You may not qualify if:

• History of Shoulder girdle fracture, dislocation and surgery
• Diagnosed with frozen shoulder or rotator cuff tear
• History of cervicobrachial pain
• Any neuromuscular pain in upper limb and use of corticosteroids or pain subsiding medication.
• Inflammatory arthropathies (e.g., rheumatoid arthritis, ankylosing spondylitis).
• Fracture or malignancy in the shoulder region
• Contraindications to manual therapy or thoracic manipulation (e.g., osteoporosis, spinal cord compression, vertebral artery insufficiency).
• Contraindications to IASTM (e.g., open wounds, skin infections, bleeding disorders, anticoagulant therapy).

Sponsors & Collaborators

• Cairo University: lead

MeSH Terms

Conditions

Shoulder Impingement Syndrome

Condition Hierarchy (Ancestors)

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

Central Study Contacts

Nabil mahmoud, professor

CONTACT

+20 12 00133613; nabil.mahmoud@cu.edu.eg

mahmoud kashef, phd

CONTACT

+20 10 94523424; Mahmoud.kashef92@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: opaque sealed envelope
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principle investigator : nabil mahmoud ismail

Model Details: Thoracic Manipulation and Instrument-assisted Soft Tissue Mobilization

Study Record Dates

• First Submitted: August 29, 2026
• First Posted: September 2, 2026
• Study Start: September 10, 2026
• Primary Completion (Estimated): May 10, 2027
• Study Completion (Estimated): May 10, 2027
• Last Updated: September 2, 2026

Record last verified: 2026-08