Clinical Research Directory

Neuropathic Pain, Catastrophizing, and Adherence in SAIS

Subacromial impingement syndrome is one of the most common causes of shoulder pain and may negatively affect daily activities and quality of life. While shoulder pain is usually considered nociceptive, some patients may also have a neuropathic pain component, which can influence symptom severity and treatment outcomes. In addition, psychological factors such as pain catastrophizing and adherence-related behavior may play an important role in recovery. This prospective observational study aims to evaluate the presence of neuropathic pain in patients with subacromial impingement syndrome and to investigate its relationship with pain catastrophizing and adherence-related behavior. Patients undergoing a standard physical therapy program will be assessed at the beginning and after completion of treatment using validated clinical scales. The findings of this study may help to better understand the interaction between pain characteristics, psychological factors, and adherence-related behavior, and contribute to the development of more individualized rehabilitation strategies

IASTM Effects on Pain, Functionality, and Proprioception in Subacromial Impingement

The aim of this study will be to investigate the effects of Instrument-Assisted Soft Tissue Mobilization (IASTM), applied in addition to a conventional exercise program, on pain, range of motion, proprioception, functionality, and quality of life in individuals with Subacromial Impingement Syndrome (SIS).

Comparison of Dynamic Ultrasound Visual Feedback to Manual Feedback on Scapular Stabilizer Activation and Change in the Subacromial Space in Persons With Pain During Shoulder Elevation

Purpose of the Study This study looks at whether using real-time ultrasound images as feedback can help people better activate two important shoulder muscles-the serratus anterior and lower trapezius-compared to standard verbal or visual feedback from a clinician. The study also examines whether this training carries over to everyday arm movements and whether it helps create more space inside the shoulder joint. Why This Matters Shoulder pain is very common. One possible cause is poor movement or poor muscle control of the shoulder blade, which can reduce the space under the shoulder and lead to pain. The serratus anterior and lower trapezius muscles help the shoulder blade move correctly when lifting the arm. Improving how these muscles work may reduce pain and improve shoulder function. How the Study Is Done People with shoulder pain will take part in the study in a university laboratory. They will be randomly placed into one of two groups: One group will receive muscle training with ultrasound images that show their muscles working in real time. The other group will receive standard feedback without ultrasound. Participants will perform specific shoulder exercises targeting the two muscles. Muscle activity will be measured before and after training using specialized sensors. The researchers will also see if the muscle training improves muscle use during a more functional movement, such as lifting the arm to shoulder height. In addition, ultrasound will be used to measure the space inside the shoulder joint before and after training. Why This Is Important for Care If ultrasound feedback is shown to be effective, it could give physical therapists and other clinicians a new tool to help patients better activate key shoulder muscles. This may improve treatment options for people with shoulder pain, especially pain at the top of the shoulder.

Effects of Myofascial Chain Tension Modulation Combined With Scapular Corrective Exercise on Scapular Movement Performance and Functional Outcomes in Tennis Players With Subacromial Impingement Syndrome

Subacromial Impingement Syndrome (SIS) is characterized by abnormal scapular motion, including decreased upward rotation, increased internal rotation, and excessive anterior tilting, which impair shoulder and arm function. Integrated scapular rehabilitation combines Instrument-Assisted Soft Tissue Mobilization (IASTM) and postural correction exercises. IASTM detects soft tissue restrictions through multidirectional strokes and enhances the pain threshold of myofascial trigger points (MTrPs) via reflex hyperemia. Postural correction exercises aim to strengthen weakened muscles and stretch tight ones to improve stability and posture. The combination of these interventions may enhance scapular stability and dynamic control. This study aimed to investigate the effects of integrated scapular rehabilitation on scapular kinematics, movement correction, functional improvement, and pain management in tennis athletes with SIS. A two-way repeated-measures ANOVA was used to analyze pre- and post-intervention effects.

Virtual Reality Based Exercise Training Versus Mulligan Mobilization on Shoulder Posture and Function in Subacromial Impingement Syndrome

The study will compare the effect of virtual reality based exercise training versus Mulligan mobilization in addition to exercise therapy added to both groups on shoulder posture and function in subacromial impingement syndrome.

Latissimus Dorsi Strengthening Exercises in Rotator Cuff Tendinopathy

The aim of this study is to investigate the effects of strengthening exercises targeting the latissimus dorsi muscle on acromiohumeral distance, shoulder function, and pain levels in individuals with rotator cuff tendinopathy. By increasing the activation of the latissimus dorsi, one of the shoulder adductor muscles, the exercises are expected to facilitate inferior gliding of the humeral head and improve subacromial distance. Individuals aged between 18 and 50 years with a diagnosis of rotator cuff tendinopathy will be included in the study. A total of 47 participants will be enrolled and randomly assigned to one of three groups: A group performing exercises targeting only the rotator cuff muscles, A group performing exercises targeting the latissimus dorsi muscle, A group performing a combination of both rotator cuff and latissimus dorsi exercises. The exercise interventions will be applied over a 12-week period. Before and after the intervention, the following outcomes will be assessed: Acromiohumeral distance (via ultrasound), Range of motion, Shoulder function and pain using the SPADI and WORC questionnaires, and Avoidance behavior using the Adap-Tr questionnaire.

Shoulder School: A Multicenter Prospective Randomized Controlled Study

Subacromial impingement syndrome (SIS) is the most common cause of shoulder pain. Patients with SIS present with localized shoulder pain, sometimes nocturnal, which leads to a decrease in shoulder strength and function, significantly affecting their quality of life. Several authors have proposed that reduced scapular movement could be a direct causal mechanism for the symptoms associated with SIS. There is evidence supporting the benefits of passive techniques applied to the scapula and thoracic spine in terms of symptom relief and improved function. The high healthcare demand from patients with SIS, combined with long waiting lists in physiotherapy, rehabilitation, and trauma services related to this dysfunction, underscores the need for a group-based therapeutic exercise strategy. Objective To analyze the effects of a shoulder school program led by a physiotherapist and based on therapeutic exercise focused on active scapular and thoracic work, compared to conventional treatment in patients with SIS referred to Primary Care Physiotherapy Units (UFAP), regarding pain, functional capacity, and quality of life. Methods Design: Single-blind, multicenter, prospective, randomized, controlled non-inferiority study. Sample: Patients with SIS referred to UFAP. Dependent Variables: Pain, functional capacity, quality of life, joint mobility, scapular function, and patient satisfaction. Independent Variables: Intervention group: Shoulder school program including exercises focused on scapular, thoracic, and rotator cuff function. Control group: Conventional physiotherapy treatment. Randomization: Cluster randomization by centers. Analysis: Data will be analyzed using SPSS version 25.0. Clinical Implications This study will provide objective data on the effects of implementing a group exercise program guided by a physiotherapist. The results could offer evidence for a resource that may be highly useful in Primary Care Physiotherapy. This approach has the potential to optimize labor, time, and space resources within this healthcare service.

The Effect of Arthroscopic Subacromial Decompression in Patients Who Are Non-responders to Non-operative Treatment.

To investigate if glenohumeral arthroscopy and arthroscopic subacromial decompression is more effective than glenohumeral arthroscopy alone in improving patient-reported outcome at 12 months in patients with subacromial impingement syndrome (SIS) who are non-responders to non-operative treatment.

Effects of KT and Scapular Stabilization Exercises.

The distance between the acromion bone and the head of the humerus narrows in subacromial impingement syndrome. This narrowing leads to the compression of sensitive structures and results in pain and decreased functional performance.While taping and scapular stabilizing exercises are commonly used in the treatment of subacromial impingement syndrome, no comparisons were conducted previously between their effectiveness. This randomized clinical trial will be conducted at Punjab Sports Board, Lahore.This study will include patients with age group ≥18 years; pain located on the anterolateral side of the shoulder for ≥3 months with positive clinical signs. Group A will receive Kinesiotaping protocol and Group B will receive Scapular Stabilization exercises protocol.

Magnetic Resonance Imaging Parameters in Patients with Subacromial Impingement Syndrome

Shoulder pain is the third most common musculoskeletal pain complaint in the world with an incidence of 7-30%. Subacromial impingement syndrome (SIS) is the most common cause of shoulder pain. Imaging in impingement syndrome is usually based on different imaging modalities. X-ray, magnetic resonance imaging (MRI) and ultrasound are the most commonly used, and MRI is considered by many authors to be the most reliable imaging modality for evaluation of the rotator cuff because it allows evaluation of soft tissues as well as bony abnormalities such as subacromial osteophytes and acromioclavicular joint capsular hypertrophy. MRI allows the diagnosis of rotator cuff tears with greater interobserver reliability than ultrasound in assessing tear size, retraction and atrophy. Few studies have investigated the impact of pathologic findings on MRI on the degree of symptoms and functional impairment seen in these patients. The aim of this study was to investigate the relationship between shoulder pain and function and MRI findings in patients with subacromial impingement syndrome.

Shoulder and Neck Mobilization in Patients With Subacromial Impingement Syndrome

Patients who come to Tavşanlı State Hospital's Physical Therapy and Rehabilitation Department and have been diagnosed with subacromial impingement syndrome by a physician will be included. Patients will be selected by randomization method among the patients determined by the physician to receive conservative treatment, shoulder mobilization in addition to conservative treatment, and neck mobilization treatment program in addition to these. Conventional treatments such as hot packs, TENS, ultrasound, and exercise will be given to all patients by the hospital staff. Pain intensity will be evaluated with VAS. Additionally, painful arch and pain-free joint range of motion evaluation will be made using a goniometer. The DASH questionnaire will be used to evaluate shoulder functionality. Sensory evaluation will be made with pressure pain threshold and two-point discrimination tests. Measurements will be made before the intervention and repeated after 3 weeks of intervention.

Subacromial Impingement Syndrome Functional Tests Correlation With Ultrasound Parameters

In this study, among the patients who applied to the Physical Medicine and Rehabilitation outpatient clinic of Muğla Training and Research Hospital and were diagnosed with subacromial impingement by anamnesis and clinical tests, inclusion criteria) and exclusion criteria will be included in the study. Demographic data of the patients will then be recorded. DASH (Disabilities of the Arm, Shoulder and Hand) and Constant Murley scores will be calculated. 4 years of musculoskeletal ultrasound experience will be recorded by a radiologist using ultrasound (Siemens® V8, LA2-14A probe) in modified Crass position (positioning with the palm of the examined side on the posterior iliac wing) by measuring subacromial bursa thickness, supraspinatus tendon thickness, acromiohumeral distance, supraspinatus tendon thickness/acromiohumeral distance ratio. Demographic data of the patients will then be recorded. DASH (Disabilities of the Arm, Shoulder and Hand) and Constant Murley scores will be calculated.

RELATION BETWEEN BODY POSTURE AND SHOULDER DYSFUNCTION

The purpose of this study will be to investigate if there is any correlation between shoulder dysfunction and the lateral alignment of the spine, scapular dyskinesia, pelvic tilting angle, Shoulder height angle, and trunk side bending (strength and mobility) in the frontal plane in patients with unilateral SIS.

Comparison of the Effectiveness Heavy Slow Resistance and Eccentric Training in Rotator Cuff Tendinopathy

Rotator cuff tendinopathy, also called subbracromial impingement syndrome, is one of the most important causes of anterior shoulder pain. Although exercise training is known as an effective intervention method in the treatment of rotator cuff/subacromial impingement problems, there is no definite consensus on which type of exercise is more effective. The aim of this study is to analyze and compare the effects of the Heavy Slow Resistance (HSR) training and eccentric exercise training on pain, function, supraspinatus tendon structure, muscle strength, range of motion, subjective perception of improvement and treatment satisfaction in individuals with subacromial shoulder pain associated with rotator cuff tendinopathy.

Operative Versus Non-operative Management of Subacromial Impingement

The study aims at determining the effectiveness and cost-effectiveness of surgical management of subacromial impingement (including partial tears) compared to conservative treatment. The research setting is prospective, randomised, and controlled. The aim of the study is to search out evidence based data of indications for subacromial decompression. The investigators also aim at offering patients the most efficient and effective treatment and reduce the number of operations that do not have sufficient effectiveness. The data obtained will facilitate developing guidelines for referrals to a specialist when subacromial impingement is suspected. The investigators hypothesise that there are subgroups of patients suffering from subacromial impingement that benefit from surgery whereas other subgroups are best treated conservatively.