Mobilization With Movement for Shoulder Impingement

Study Overview
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Brief Summary
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Controversy exists regarding the effectiveness of manual therapy techniques for the management of impingement syndrome. However, no adequately powered clinical trials have examined the effects of mobilization-with-movement. The purpose of the current study was to perform a randomized controlled trial comparing the effects of real MWM to a group receiving a sham intervention on shoulder pain at different moments and active shoulder range of motion in an adequately powered sample of patients with shoulder impingement syndrome.

Official Title
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Effects of Mobilization-with-Movement on Pain and Range of Motion in Unilateral Shoulder Impingement Syndrome: A Randomized Controlled Trial

Conditions
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Shoulder Impingement Syndrome

Intervention / Treatment
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* Other: Real mobilization-with-movement (MWM)
* Other: Sham mobilization-with-movement (MWM)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: history of shoulder pain of > 3months duration pain localized at the proximal anterolateral shoulder region medical diagnosis of shoulder impingement syndrome at least 2 positive impingement tests including Neer, Hawking, or Jobe test Exclusion Criteria: diagnosis of fibromyalgia pregnancy a history of traumatic onset of shoulder pain other histories of shoulder injury ligamentous laxity based on a positive Sulcus test and apprehension test numbness or tingling in the upper extremity previous shoulder or cervical spine surgery corticosteroid injection on the shoulder within 1 year of the study physical therapy 6 months prior to the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Real mobilization-with-movement (MWM)<br>For the MWM group, an accessory posterior-lateral gliding movement in the humeral head combined with a movement of active shoulder flexion will be applied. One hand will be placed over the scapula posteriorly while the thenar eminence of the other hand will be placed over the anterior aspect of the head of the humerus | Other: Real mobilization-with-movement (MWM)<br> <br> |
| Sham Comparator: Sham mobilization-with-movement (MWM)<br>The sham condition will replicate the treatment condition except for the hand positioning. The therapist locates one hand over the belly of the pectoralis major muscle and the other over scapula without applying any pressure. The patient will be asked to move the arm in a similar manner as in the MWM group | Other: Sham mobilization-with-movement (MWM)<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in the intensity of shoulder pain before and after the treatment | Participants were asked to rate the intensity of their pain using an 11-point numerical pain rating scale (NPRS; 0: no pain; 10: maximum pain) for 3 scores of perceived pain: 1, the intensity of shoulder pain experienced in the last 24h; 2, the intensity of shoulder pain at night; 3, the intensity of shoulder pain during shoulder flexion. | Baseline and one week after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in shoulder range of motion before and after the treatment | A universal goniometer was used to assess the participant's shoulder range of motion in the following motions: Pain-free and maximum (painful) range of motion in shoulder flexion Pain-free range of motion in shoulder extension Pain-free range of motion in shoulder abduction Pain-free range of motion in shoulder external rotation Pain-free range of motion in shoulder medial (internal) rotation | Baseline and one week after the intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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shoulder impingement, manual therapy, pain, motion.