Clinical trial NCT05104671: Thoracic Manipulation Versus Myofascial Release in Patients With Shoulder Impingement Syndrome
Official title: Thoracic Manipulation Versus Myofascial Release in Patients With Shoulder Impingement Syndrome
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Impingement Shoulder
Lead sponsor: Cairo University
Sponsor class: OTHER
Collaborators: name: Cairo University
First posted: 2021-11-03
Enrollment: 60
Sex: ALL
Minimum age (years): 25
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: aims: • To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on pain intensity.

* To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on pain pressure threshold.
* To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on shoulder proprioception.
* To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on shoulder range of motion(ROM).
* To investigate the effect of adding thoracic manipulation vs myofascial release to scapular stabilization exercise on disability of shoulder and hand questionnaire(DASH).

Detailed description: Various researches have been done on rehabilitation of shoulder impingement by addressing either osseous structure or myofascial structure and found to be effective. But no studies could retrieve to compare these two: myofascial release and thoracic manipulation. (Dash \& Deepak, 2020). so in this study we will investigate the effect of adding thoracic manipulation versus myofascial release in patients with shoulder impingement syndrome. we will investigate the effect on each of the following: pain intensity will measure by visual analogue scale.(VAS).

proprioception of the shoulder by isokinetic dynamometer. pain pressure threshold by algometer. function by DASH questionnaire and finally ROM by kinovea software.

The subjects will be arranged into three groups: Group I (control group) will receive scapular stabilization exercises.

* Group II will receive scapular stabilization exercises and thoracic manipulation combined with shoulder mobilization.
* Group III will receive scapular stabilization exercises and myofascial release by instrument assisted soft tissue mobilization techniques(IASTM).

the measurements will take before and after treatment programs and after one month of follow up.

Eligibility criteria: Inclusion Criteria:

1. Sixty patients with shoulder impingement syndrome from both genders their age will be ranged and divided into three groups from 25-40 years.
2. History of shoulder pain for at least one month.
3. Positive Neer's impingement test and Hawkins's kiennedy test.
4. Presence of thoracic hypomobility from clinical evaluation.
5. Provocation of pain above 60 degrees of flexion and abduction.
6. Palpable trigger points on shoulder muscles.

Exclusion Criteria:

1. History of Shoulder girdle fracture, dislocation and surgery
2. Diagnosed with frozen shoulder or rotator cuff tear
3. History of cervicobrachial pain
4. Any neuromuscular pain in upper limb and use of corticosteroids or pain subsiding medication

Primary outcomes:
measure: Pain in shoulder movement
timeFrame: change from max pain point at 2 months
measure: shoulder function
timeFrame: change from limitation of function at 2 months
measure: Shoulder Proprioception (joint of position error)
timeFrame: change from poor proprioception at 2 months
Secondary outcomes:
measure: Shoulder ROM
timeFrame: change from limitation in shoulder ROM at 2 months
measure: Pain pressure threshold in shoulder muscles
timeFrame: change from baseline pain pressure threshold at 2 months
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Cairo University
Study officials:
References: