The Immediate Effect of Mulligan's Mobilization With Movement on Shoulder Girdle' Pain, Range of Motion and Muscle Activity, in Subjects With Shoulder Impingement Syndrome

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 Any age
• All sexes
• No healthy volunteers
• Child, Adult, Older adult

Trial locations and contacts

1 site in 1 country.

About this study

Conditions

Shoulder Impingement Syndrome

Being tested

Mulligan's Mobilization With Movement, Active Mobilization

Keywords

Subacromial impingement syndrome, Mobilization with movement, Pressure pain threshold, Surface electromyography

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.

• Mulligan's Mobilization With MovementProcedure or surgery

  Also called MWM

  The Mulligan's MWM group received mobilization with movement in the glenohumeral joint, as described by Mulligan. The participant was seated, and the physiotherapist was placed on the opposite side to the affected shoulder with the thenar eminence of one hand over the anterior aspect of the humeral head, and the other hand over the spine of the scapula posteriorly of the affected shoulder. The hand over the humeral head performed a posterolateral glide, while the other hand stabilized the scapula. This maneuver was sustained while the participant asked to raise the arm in scapular plan (as explained above) without pain. The physiotherapist previously determined the amount of posterolateral pressure which was the best to abolish the pain during shoulder scaption for each participant. The participants performed three sets of 10 trials with a resting time of 30 seconds between each set. After intervention was allowed a resting time of three minutes.

• Active MobilizationProcedure or surgery

  In the Placebo group, no effective intervention was performed, the participant was asked to raise the affected arm in scapular plane without pain, while the physiotherapist placed their hands-on shoulder, with the same manual contacts described in Mulligan's MWM group, but without performing any pressure.

  The participants performed three sets of 10 trials with a resting time of 30 seconds between each set. After intervention was allowed a resting time of three minutes.

What is being measured

The primary outcome is the main question the study is designed to answer.

1. Pain intensity

   The participant was asked to rate the pain intensity in Neer impingement signal and Hawkins-Kennedy impingement test, using a 100 mm visual analogue scale.

   Measured: baseline

2. Pain Pressure Threshold on the lateral aspect of shoulder

   Pressure algometry was performed to assess PPT on the lateral aspect of shoulder. A hand-held electronic pressure algometer Force One FDIX (Wagner Instruments, Greenwich CT, United States of America) with a 1 cm2 rubber-tipped probe area was applied perpendicular to the skin at a rate of 1 kg per second. The PPT was measured over the most sensitive point to manual palpation of the lateral aspect of shoulder. This region was marked with a permanent marker so that the same point could be used pre- and post-intervention. The researcher instructed the participant to say "ouch" as soon as sensation changed from feeling pressure to feeling pain. Three trials were performed, with a resting time of 30 seconds and a subsequent analysis of its average.

   Measured: baseline

3. Shoulder ROM

   Photogrammetry was performed to assess ROM of shoulder scaption until onset of pain. The ROM was recorded by photography, using a digital camera (30 frames/ second) placed in a perpendicular position to the plane of motion, at a distance of 3 meters from a flat surface. The photography was subsequently analyzed by a postural analysis software (SAPo version 0.69, open source software). To ensure consistent reference points, spherical markers were placed on the skin: one over the acromion and the last over the lateral epicondyle. The participant was asked to raise the arm until feeling pain, with elbow fully extended and thumb pointed up along a flat vertical surface positioned 30º anterior to the frontal plane.

   Measured: baseline

4. Shoulder muscle activity

   Surface electromyography (sEMG) was performed to assess the muscle activity of trapezius (upper, middle and lower) and SA, during concentric and eccentric phases of shoulder scaption. The muscle activity was recorded by BioPlux research device (Plux wireless biosignals S.A., Arruda dos Vinhos, Portugal) with 12-bit analog channels and a sampling frequency of 1000 Hz, using double differential electrode leads. To perform sEMG, the participant's hair was shaved, an abrasive cream was used to remove dead cells from the skin's surface, and the skin was cleaned with isopropyl alcohol (70%) to remove oil and remaining dead cells. An electrode impedance checker (Noraxon Corporate, Scottsdale AZ, United States of America) was used to ensure that impedance levels were less than 5 KΩ, which was considered to signify the satisfactory acquisition of the sEMG signal.

   Measured: baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

1. First posted1 May 2025
2. Study start1 Jan 2023
3. Primary completion31 Jul 2023
4. Study completion31 Jul 2023

Resources

• Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
• Other trials for Shoulder Impingement SyndromeStudies 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.