Rotator Cuff InjuriesNCT07525297
Mulligan's Mobilization in Rotator Cuff Pathology
A study testing Mulligan Mobilization with Movement, Thoracic Spine Mobilization and Conventional Physiotherapy Program in people with Rotator Cuff Injuries, run by Yuzuncu Yil University at 1 site in Turkey (Türkiye).
Trial summary
Rotator cuff pathology is defined as the degeneration or tear of one or more of the muscles or tendons of the rotator cuff, namely the supraspinatus, infraspinatus, teres minor, and subscapularis. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Rotator Cuff Injuries
- What is being tested?
- Mulligan Mobilization with Movement, Thoracic Spine Mobilization and Conventional Physiotherapy Program
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 20 Apr 2026to 20 Oct 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Having been diagnosed with unilateral rotator cuff pathology (impingement syndrome, tendinopathy, or partial tear) by a specialist physician through clinical examination and/or radiological imaging (USG/MR);
- Being between 18 and 65 years of age;
- Having shoulder pain that has persisted for at least 3 months;
- Having a positive result on at least two of the Neer, Hawkins-Kennedy, and Empty Can tests;
- Having a pain intensity of at least 3/10 on the Pain Numerical Rating Scale (NPRS) during rest or activity;
- Having sufficient cognitive ability to follow simple instructions and administer the tests;
- Having a Mini Mental State Test score ≥24;
- Having the ability to provide signed informed consent and agreeing to participate in the study voluntarily.
Who cannot join
- Having undergone previous surgery on the shoulder or thoracic region;
- Having full-thickness rotator cuff tears requiring surgical indication;
- Having adhesive capsulitis, shoulder instability, labrum tears, or calcific tendinitis;
- Having cervical radiculopathy or neurological diseases affecting the upper extremity;
- Having uncontrolled diabetes, inflammatory rheumatic diseases (rheumatoid arthritis, etc.), or malignancy;
- Having severe osteoporosis, unstable vertebral fractures, or active infection in the thoracic region;
- having received steroid (cortisone) or PRP injections to the shoulder region within the last 3 months.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: The Effect of Adding Thoracic Mobilization to Mulligan's Mobilization With Movement in Individuals With Rotator Cuff Pathology
Rotator cuff pathology is defined as the degeneration or tear of one or more of the muscles or tendons of the rotator cuff, namely the supraspinatus, infraspinatus, teres minor, and subscapularis. Shoulder girdle biomechanics are not solely comprised of the glenohumeral joint but are built upon a kinetic chain involving the synchronized movement of the scapula, clavicle, and thoracic spine. In this context, the concept described in the literature as the "Regional Dependence" model argues that functional impairment in a distal segment like the shoulder may stem from or exacerbate limitations in a more proximal region like the thoracic spine. Conventional treatment approaches that focus solely on the shoulder joint may have limited clinical outcomes due to neglecting the fundamental link in the kinetic chain. Maintained natural apophyseal glides (SNAGs), a cornerstone of Mulligan's Concept in spinal rehabilitation, are a dynamic manual therapy technique aimed at correcting microscopic misalignments in facet joints during active movement. The aim of this randomized controlled trial is to investigate the effects of thoracic mobilization added to the Mulligan movement shoulder mobilization technique on pain intensity, range of motion, proprioception, and upper extremity functionality in individuals with rotator cuff pathology, and to evaluate the superiority of this combined approach over shoulder mobilization alone. Assessments will be performed before treatment and at the end of the 3-week intervention. Rest and activity pain intensity will be assessed using the Pain Numerical Rating Scale (PMR), shoulder range of motion using a digital goniometer, thoracic kyphosis degrees using a smartphone with the 'Angle Meter' software installed and calibrated gyroscope and accelerometer sensors, functionality using the Shoulder Pain and Disability Index (SPAI), and proprioception using a laser pointer and target device. The obtained data will be compared using appropriate statistical analysis methods. This study is expected to provide scientific evidence regarding the clinical effectiveness of thoracic mobilization technique added to shoulder mobilization technique applied in conjunction with conventional treatment in individuals with rotator cuff pathology, and to contribute to filling the methodological gap mentioned in the literature.
- Conditions
- Rotator Cuff Injuries
- Being tested
- Mulligan Mobilization with Movement, Thoracic Spine Mobilization, Conventional Physiotherapy Program
- Keywords
- Rotator cuff injuries, Manual therapy, Exercise, Shoulder joint, Thoracic Vertebrae
- Medical subject headings
- Rotator Cuff Injuries, Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Mulligan Mobilization with MovementProcedure or surgery
Mobilization with Movement technique applied to the shoulder joint according to Mulligan concept to improve pain and range of motion.
Thoracic Spine MobilizationProcedure or surgery
Manual mobilization techniques applied to thoracic spine segments to improve thoracic mobility and contribute to shoulder function.
Conventional Physiotherapy ProgramOther
Conventional physiotherapy program including hot pack application (20 minutes), TENS (80-100 Hz frequency, 50-100 µs impulse duration, 20 minutes), therapeutic ultrasound (1-3 MHz frequency, 1.0-1.5 W/cm² intensity, continuous mode, 7 minutes), and supervised exercise program consisting of pendulum exercises, stick exercises for range of motion, scapular stabilization exercises (retraction, Y-W-T), and progressive strengthening exercises (isometric and dynamic) for rotator cuff muscles.
| Study group | Role | What they receive |
|---|---|---|
| Control Group | Active comparator | Conventional Physiotherapy Program, Mulligan Mobilization with Movement Receives: Procedure: Mulligan Mobilization with Movement; Other: Conventional Physiotherapy Program |
| Intervention Group | Experimental | Conventional Physiotherapy Program, Mulligan Mobilization with Movement and Thoracic Spine Mobilization Receives: Procedure: Mulligan Mobilization with Movement; Procedure: Thoracic Spine Mobilization; Other: Conventional Physiotherapy Program |
What is being measured
The primary outcome is the main question the study is designed to answer.
Thoracic kyphosis angle
Participants' thoracic kyphosis degrees will be measured via a smartphone equipped with 'Angle Meter' software, a digital inclinometer.
Measured: From enrollment to the end of treatment at 3 weeks
Proprioception
Proprioception will be assessed using a laser pointer and millimeter graph paper. The laser pointer will be secured to the participant's arm just above the lateral epicondyle, parallel to the arm, using an elastic bandage. The participant will be positioned in a seated position 1 meter away from the millimeter graph paper. The amount of linear deviation on the millimeter graph paper will be converted into angular error using a trigonometric formula based on the distance between the center of the shoulder joint and the paper.
Measured: "From enrollment to the end of treatment at 3 weeks
Range of motion
Range of motion will be assessed using a universal goniometer.
Measured: "From enrollment to the end of treatment at 3 weeks
Secondary outcomes (2)
Shoulder pain
Shoulder pain will be assessed with Numerical Pain Rating Scale. Pain intensity is assessed on a numerical scale of 0-10; 0 = no pain, 5 = moderate pain, 10 = unbearable pain.
Measured: From enrollment to the end of treatment at 3 weeks
Shoulder Functionality
Functionality will be assessed with Shoulder Pain Disability Index.
Measured: From enrollment to the end of treatment at 3 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Apr 2026
- Study start20 Apr 2026 (estimated)
- Primary completion20 Sep 2026 (estimated)
- Study completion20 Oct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Rotator Cuff InjuriesStudies 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
- None (open label)
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Yuzuncu Yil University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ayse Merve TAT, Yuzuncu Yil University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07525297
- Sponsor's protocol ID
- YuzuncuYil 2026- Shoulder MT
- Status last verified
- Apr 2026
- First submitted
- 6 Apr 2026
- Last updated
- 13 Apr 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 13 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Adding Thoracic Mobilization to Mulligan's Mobilization With Movement in Individuals With Rotator Cuff Pathology
- ClinicalTrials.gov ID
- NCT07525297
- Acronym / sponsor ID
- YuzuncuYil 2026- Shoulder MT
- Conditions
- Rotator Cuff Injuries
- Keywords
- Rotator cuff injuries, Manual therapy, Exercise, Shoulder joint, Thoracic Vertebrae
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Yuzuncu Yil UniversityUniversity, hospital or other
- Study start
- 20 Apr 2026 (estimated)
- Primary completion
- 20 Sep 2026 (estimated)
- Study completion
- 20 Oct 2026 (estimated)
- First posted
- 13 Apr 2026 (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.
Rotator cuff pathology is defined as the degeneration or tear of one or more of the muscles or tendons of the rotator cuff, namely the supraspinatus, infraspinatus, teres minor, and subscapularis. Shoulder girdle biomechanics are not solely comprised of the glenohumeral joint but are built upon a kinetic chain involving the synchronized movement of the scapula, clavicle, and thoracic spine. In this context, the concept described in the literature as the "Regional Dependence" model argues that functional impairment in a distal segment like the shoulder may stem from or exacerbate limitations in a more proximal region like the thoracic spine. Conventional treatment approaches that focus solely on the shoulder joint may have limited clinical outcomes due to neglecting the fundamental link in the kinetic chain. Maintained natural apophyseal glides (SNAGs), a cornerstone of Mulligan's Concept in spinal rehabilitation, are a dynamic manual therapy technique aimed at correcting microscopic misalignments in facet joints during active movement. The aim of this randomized controlled trial is to investigate the effects of thoracic mobilization added to the Mulligan movement shoulder mobilization technique on pain intensity, range of motion, proprioception, and upper extremity functionality in individuals with rotator cuff pathology, and to evaluate the superiority of this combined approach over shoulder mobilization alone. Assessments will be performed before treatment and at the end of the 3-week intervention. Rest and activity pain intensity will be assessed using the Pain Numerical Rating Scale (PMR), shoulder range of motion using a digital goniometer, thoracic kyphosis degrees using a smartphone with the 'Angle Meter' software installed and calibrated gyroscope and accelerometer sensors, functionality using the Shoulder Pain and Disability Index (SPAI), and proprioception using a laser pointer and target device. The obtained data will be compared using appropriate statistical analysis methods. This study is expected to provide scientific evidence regarding the clinical effectiveness of thoracic mobilization technique added to shoulder mobilization technique applied in conjunction with conventional treatment in individuals with rotator cuff pathology, and to contribute to filling the methodological gap mentioned in the literature.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Control Group | Active comparator | Procedure: Mulligan Mobilization with Movement, Other: Conventional Physiotherapy ProgramConventional Physiotherapy Program, Mulligan Mobilization with Movement |
| Intervention Group | Experimental | Procedure: Mulligan Mobilization with Movement, Procedure: Thoracic Spine Mobilization, Other: Conventional Physiotherapy ProgramConventional Physiotherapy Program, Mulligan Mobilization with Movement and Thoracic Spine Mobilization |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Having been diagnosed with unilateral rotator cuff pathology (impingement syndrome, tendinopathy, or partial tear) by a specialist physician through clinical examination and/or radiological imaging (USG/MR);
- Being between 18 and 65 years of age;
- Having shoulder pain that has persisted for at least 3 months;
- Having a positive result on at least two of the Neer, Hawkins-Kennedy, and Empty Can tests;
- Having a pain intensity of at least 3/10 on the Pain Numerical Rating Scale (NPRS) during rest or activity;
Key exclusion criteria (7 listed)
- Having undergone previous surgery on the shoulder or thoracic region;
- Having full-thickness rotator cuff tears requiring surgical indication;
- Having adhesive capsulitis, shoulder instability, labrum tears, or calcific tendinitis;
- Having cervical radiculopathy or neurological diseases affecting the upper extremity;
- Having uncontrolled diabetes, inflammatory rheumatic diseases (rheumatoid arthritis, etc.), or malignancy;
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 |
|---|---|---|
| Mulligan Mobilization with MovementMobilization with Movement technique applied to the shoulder joint according to Mulligan concept to improve pain and range of motion. | Procedure or surgery | Control Group, Intervention Group |
| Thoracic Spine MobilizationManual mobilization techniques applied to thoracic spine segments to improve thoracic mobility and contribute to shoulder function. | Procedure or surgery | Intervention Group |
| Conventional Physiotherapy ProgramConventional physiotherapy program including hot pack application (20 minutes), TENS (80-100 Hz frequency, 50-100 µs impulse duration, 20 minutes), therapeutic ultrasound (1-3 MHz frequency, 1.0-1.5 W/cm² intensity, continuous mode, 7 minutes), and supervised exercise program consisting of pendulum exercises, stick exercises for range of motion, scapular stabilization exercises (retraction, Y-W-T), and progressive strengthening exercises (isometric and dynamic) for rotator cuff muscles. | Other | Control Group, Intervention Group |
Primary outcome
Thoracic kyphosis angle
Time frame: From enrollment to the end of treatment at 3 weeks
Participants' thoracic kyphosis degrees will be measured via a smartphone equipped with 'Angle Meter' software, a digital inclinometer.
Proprioception
Time frame: "From enrollment to the end of treatment at 3 weeks
Proprioception will be assessed using a laser pointer and millimeter graph paper. The laser pointer will be secured to the participant's arm just above the lateral epicondyle, parallel to the arm, using an elastic bandage. The participant will be positioned in a seated position 1 meter away from the millimeter graph paper. The amount of linear deviation on the millimeter graph paper will be converted into angular error using a trigonometric formula based on the distance between the center of the shoulder joint and the paper.
Range of motion
Time frame: "From enrollment to the end of treatment at 3 weeks
Range of motion will be assessed using a universal goniometer.
2 secondary outcomes
Shoulder pain
Time frame: From enrollment to the end of treatment at 3 weeks
Shoulder Functionality
Time frame: From enrollment to the end of treatment at 3 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Apr 2026.
- Individual participant dataSharing planned: 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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Mulligan Mobilization with Movement, Thoracic Spine Mobilization and Conventional Physiotherapy Program in people with Rotator Cuff Injuries, run by Yuzuncu Yil University at 1 site in Turkey (Türkiye).
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 8 inclusion and 7 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: opening soon, as of the sponsor's last update on 13 Apr 2026. 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 Turkey (Türkiye). 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Ayşe Merve Tat, Assistant Professor (+900505243111, aysemervetat@yyu.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Thoracic kyphosis angle (time frame: From enrollment to the end of treatment at 3 weeks). 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 13 Apr 2026.