Impingement ShoulderNCT05104671
Thoracic Manipulation Versus Myofascial Release in Patients With Shoulder Impingement Syndrome
A study testing scapular stabilization exercises., Thoracic manipulation. and Myofascial release. in people with Impingement Shoulder, run by manar sameh el taher at 1 site in Egypt.
Trial 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. Read more about this study
- Who is it for?
- Ages 25 to 40 years
- Conditions the study is for
- Impingement Shoulder
- What is being tested?
- scapular stabilization exercises., Thoracic manipulation. and Myofascial release.
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Dec 2021to 15 May 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 25 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Sixty patients with shoulder impingement syndrome from both genders their age will be ranged and divided into three groups from 25-40 years.
- History of shoulder pain for at least one month.
- Positive Neer's impingement test and Hawkins's kiennedy test.
- Presence of thoracic hypomobility from clinical evaluation.
- Provocation of pain above 60 degrees of flexion and abduction.
- Palpable trigger points on shoulder muscles.
Who cannot join
- 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
Trial locations and contacts
1 site in 1 country.
About this study
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).
Read the 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.
- Conditions
- Impingement Shoulder
- Being tested
- scapular stabilization exercises., Thoracic manipulation., Myofascial release.
- Medical subject headings
- Shoulder Impingement Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
scapular stabilization exercises.Other
General Instructions: For all exercises, perform the retraction of the scapula, without performing the elevation of the shoulders, taking the lower angle of the scapula "back and down".
The exercise intensity was described as repetitions, sets, and holding time. Commonly, 10-20 repetitions and three to five sets held for 3-10 seconds were performed.and the exercises will be:
- towel slide
- Scapular Clock:
- Scapular Proprioceptive Neuromuscular facilitation:
- Inferior Glide.
- Scapular Orientation Exercise (SOE):
- Protraction and retraction in front of a mirror:
Thoracic manipulation.Other
Also called scapular stabilization exercises
- Thoracic Thrust Manipulation: The participants were in high sitting and in prone lying position. The therapist was standing next to the patient in a diagonal stance and also behind the patient during high sitting. Thoracic thrust manipulation demonstrated to manipulate specific thoracic segment mainly mid thoracic.
Myofascial release.Other
Also called scapular stabilization exercises
The subject will be treated with IASTM.applied to the pectoral muscles and medial brachium with the subject in supine and the glenohumeral joint(GH). placed in 120 º abduction to place adequate tension on the selected tissues in the style of pectoral tightness test .The IASTM technique was 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 º angle to the skin.The same IASTM protocol of 20 seconds parallel to the muscle fibers and 20 seconds perpendicular to the muscle fibers was applied to the posterior cuff musculature of the GH joint with the subject in prone and arms in 90 º abduction and internal rotation draped over the side of the plinth . While in the same position, the technique was applied to the periscapular musculature including the, trapezoids, rhomboids, teres minor, teres major, and latissimus dorsi.
| Study group | Role | What they receive |
|---|---|---|
| Scapular stabilization exercises | Active comparator | Group I (control group) will receive scapular stabilization exercises. Receives: Other: scapular stabilization exercises. |
| Thoracic manipulation. | Experimental | Group II will receive scapular stabilization exercises and thoracic manipulation. Receives: Other: scapular stabilization exercises.; Other: Thoracic manipulation. |
| Myofascial release | Experimental | Group III will receive scapular stabilization exercises and myofascial release by instrument assisted soft tissue mobilization techniques. Receives: Other: scapular stabilization exercises.; Other: Myofascial release. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain in shoulder movement
will be measured by Visual analog scale(VAS). It consists of a line, often 10 cm long(100mm); its ends are generally labelled with verbal pain anchors (e.g., "no pain" and "pain as bad as it could be"). Patients are asked to indicate the point along the line that best reflects their pain intensity. The majority of the studies showed that visual analogue scale is a valid and reliable scale. Also, it is an interval scale. So, in clinical practice we can use this scale in case of pain measurement as an outcome measure tool.
Measured: change from max pain point at 2 months
shoulder function
by DASH is a reliable and valid tool for the assessment of shoulder pain and disability in both clinical practice and research.
Measured: change from limitation of function at 2 months
Shoulder Proprioception (joint of position error)
will be measured by isokinetic dynamometer. Isokinetic dynamometry is considered a valid instrument for assessing muscle strength, and it is often used as a reference standard for other strength assessments.
Measured: change from poor proprioception at 2 months
Secondary outcomes (2)
Shoulder ROM
will be measured by Kinovea. Kinovea is a free software used for the analysis, comparison, and evaluation of sports and training. it is a reliable tool for measuring shoulder flexion, abduction, and Internal rotation\&external rotation in healthy individuals. Thus, it could be used as a simple alternative to universal goniometry.
Measured: change from limitation in shoulder ROM at 2 months
Pain pressure threshold in shoulder muscles
that Pressure algometer is a worthwhile tool in the diagnosis and treatment evaluation of different orthopedic disorders. . Three consecutive Pressure pain threshold measurements were taken at each point with 20 s rest between measurements, and the mean of the three trials will be used for analysis.
Measured: change from baseline pain pressure threshold at 2 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Nov 2021
- Study start1 Dec 2021
- Primary completion15 May 2023
- Study completion15 May 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Impingement ShoulderStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- manar sameh el taher
- Sponsor type
- University, hospital or other
- Collaborators
- Cairo University
- Responsible party
- Sponsor-investigator, manar sameh el taher, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05104671
- Sponsor's protocol ID
- shoulder impingement
- Status last verified
- Jul 2025
- First submitted
- 18 Jul 2021
- Last updated
- 24 Jul 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Undecided
Study at a glance
From the registry record, last updated by the sponsor on 24 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Thoracic Manipulation Versus Myofascial Release in Patients With Shoulder Impingement Syndrome
- ClinicalTrials.gov ID
- NCT05104671
- Acronym / sponsor ID
- shoulder impingement
- Conditions
- Impingement Shoulder
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- manar sameh el taherUniversity, hospital or other
- Collaborators
- Cairo University
- Study start
- 1 Dec 2021 (actual)
- Primary completion
- 15 May 2023 (actual)
- Study completion
- 15 May 2023 (actual)
- First posted
- 3 Nov 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Scapular stabilization exercises | Active comparator | Other: scapular stabilization exercises.Group I (control group) will receive scapular stabilization exercises. |
| Thoracic manipulation. | Experimental | Other: scapular stabilization exercises., Other: Thoracic manipulation.Group II will receive scapular stabilization exercises and thoracic manipulation. |
| Myofascial release | Experimental | Other: scapular stabilization exercises., Other: Myofascial release.Group III will receive scapular stabilization exercises and myofascial release by instrument assisted soft tissue mobilization techniques. |
Who may qualify
- Ages
- 25 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- Sixty patients with shoulder impingement syndrome from both genders their age will be ranged and divided into three groups from 25-40 years.
- History of shoulder pain for at least one month.
- Positive Neer's impingement test and Hawkins's kiennedy test.
- Presence of thoracic hypomobility from clinical evaluation.
- Provocation of pain above 60 degrees of flexion and abduction.
Key exclusion criteria (4 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| scapular stabilization exercises.General Instructions: For all exercises, perform the retraction of the scapula, without performing the elevation of the shoulders, taking the lower angle of the scapula "back and down". The exercise intensity was described as repetitions, sets, and holding time. Commonly, 10-20 repetitions and three to five sets held for 3-10 seconds were performed.and the exercises will be: 1. towel slide 2. Scapular Clock: 3. Scapular Proprioceptive Neuromuscular facilitation: 4. Inferior Glide. 5. Scapular Orientation Exercise (SOE): 6. Protraction and retraction in front of a mirror: | Other | Myofascial release, Scapular stabilization exercises, Thoracic manipulation. |
| Thoracic manipulation.Also: scapular stabilization exercises• Thoracic Thrust Manipulation: The participants were in high sitting and in prone lying position. The therapist was standing next to the patient in a diagonal stance and also behind the patient during high sitting. Thoracic thrust manipulation demonstrated to manipulate specific thoracic segment mainly mid thoracic. | Other | Thoracic manipulation. |
| Myofascial release.Also: scapular stabilization exercisesThe subject will be treated with IASTM.applied to the pectoral muscles and medial brachium with the subject in supine and the glenohumeral joint(GH). placed in 120 º abduction to place adequate tension on the selected tissues in the style of pectoral tightness test .The IASTM technique was 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 º angle to the skin.The same IASTM protocol of 20 seconds parallel to the muscle fibers and 20 seconds perpendicular to the muscle fibers was applied to the posterior cuff musculature of the GH joint with the subject in prone and arms in 90 º abduction and internal rotation draped over the side of the plinth . While in the same position, the technique was applied to the periscapular musculature including the, trapezoids, rhomboids, teres minor, teres major, and latissimus dorsi. | Other | Myofascial release |
Primary outcome
Pain in shoulder movement
Time frame: change from max pain point at 2 months
will be measured by Visual analog scale(VAS). It consists of a line, often 10 cm long(100mm); its ends are generally labelled with verbal pain anchors (e.g., "no pain" and "pain as bad as it could be"). Patients are asked to indicate the point along the line that best reflects their pain intensity. The majority of the studies showed that visual analogue scale is a valid and reliable scale. Also, it is an interval scale. So, in clinical practice we can use this scale in case of pain measurement as an outcome measure tool.
shoulder function
Time frame: change from limitation of function at 2 months
by DASH is a reliable and valid tool for the assessment of shoulder pain and disability in both clinical practice and research.
Shoulder Proprioception (joint of position error)
Time frame: change from poor proprioception at 2 months
will be measured by isokinetic dynamometer. Isokinetic dynamometry is considered a valid instrument for assessing muscle strength, and it is often used as a reference standard for other strength assessments.
2 secondary outcomes
Shoulder ROM
Time frame: change from limitation in shoulder ROM at 2 months
Pain pressure threshold in shoulder muscles
Time frame: change from baseline pain pressure threshold at 2 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Jul 2025.
- Individual participant dataSharing planned: No. Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing scapular stabilization exercises., Thoracic manipulation. and Myofascial release. in people with Impingement Shoulder, run by manar sameh el taher at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 24 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain in shoulder movement (time frame: change from max pain point at 2 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Jul 2025.