The Effect of Thoracic Mobilization in Individuals With Subacromial Pain Syndrome

Hacettepe University

Status: Completed

Conditions: Subacromial Pain Syndrome

Treatments: Other: Exercise Group; Other: Thoracic Mobilization Group

Study type: Interventional

Funder types: Other

Identifiers

NCT06374004

HU-FTR-MC-01

Details and patient eligibility

About

The purpose of this study is to investigate the effect of six-week thoracic mobilization on pain intensity, muscle tone, functional and muscle activation in individuals with subacromial pain syndrome.

Full description

Subacromial pain syndrome (SAPS) is the most common shoulder problem and accounts for 44%-65% of all shoulder problems. Repetitive compression of the rotator cuff tendons as they pass through the subacromial space affects shoulder function along with pain.

Studies have shown that scapular kinematics are affected in individuals with subacromial pain syndrome. In addition to increased scapular internal rotation, scapular upward rotation and posterior tilt during elevation are decreased in these individuals. These kinematic changes have been associated with decreased activation of the middle and lower trapezius and serratus anterior muscles and excessive upper trapezius activation. This change in scapular kinematics causes narrowing of the subacromial space and repeated traumatization of the rotator cuff muscles passing through it. In addition, kyphotic posture in the thoracic region (insufficient extension of the thoracic vertebrae) negatively affects scapular kinematics. Kyphotic posture has been shown to be associated with subacromial pain syndrome by causing anterior tilt, downward rotation and protraction in the scapula.

Exercise and mobilization applications are frequently applied in subacromial pain syndrome. Strengthening the muscles around the shoulder and scapula, increasing glenohumeral and scapulothoracic joint mobility, and stretching the posterior capsule are frequently applied to reduce pain and increase function. Studies on increasing thoracic mobilization are limited in number. In these studies, the acute effects of thoracic manipulation applications on pain, normal joint motion and functional activity level were examined in individuals with subacromial pain syndrome. There is only one pilot study that examined the effect of mobilization applied to the thoracic region. The purpose of this study is to investigate the effect of six-week thoracic mobilization on pain intensity, muscle tone, functional and muscle activation in individuals with subacromial pain syndrome.

Enrollment: 32 patients

Sex: All

Ages: 18 to 50 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Thoracic kyphosis angle > 40°
• Full active shoulder abduction

Exclusion criteria

• Bilateral shoulder pain
• Rotator cuff tear
• Shoulder/cervical injury other than SAPS
• Surgery history

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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32 participants in 2 patient groups

Exercise Group

Active Comparator group

Description:

The exercise group will perform stretching and strengthening exercises involving the muscle groups around the shoulder and scapula for 12 weeks.

Treatment:

Other: Exercise Group

Thoracic Mobilization Group

Active Comparator group

Description:

The exercise group will perform stretching and strengthening exercises involving the muscle groups around the shoulder and scapula for 12 weeks. In addition to the exercises, thoracic mobilization will be applied to the participants in this group 1 day a week for a total of 6 weeks.

Treatment:

Other: Thoracic Mobilization Group

Other: Exercise Group