Subacromial Impingement SyndromeCSEs in SISNCT07645781
Cervical Stabilization Exercises IN Subacromial Impingement Syndrome
A study testing Conventional Physical Therapy and Cervical Stabilization in people with Subacromial Impingement Syndrome and Pain, run by Cairo University at 1 site in Egypt.
Trial summary
The goal of this clinical trial study is to determine efficacy of adding cervical stabilization exercises (CSEs) to conventional physical therapy (PT) program on pain severity, shoulder function disability, kinesiophobia, shoulder range of motion (ROM), isometric muscle strength and upper limb (UL) functional activity… Read more about this study
- Who is it for?
- Ages 20 to 40 years
- Conditions the study is for
- Subacromial Impingement Syndrome, Pain
- What is being tested?
- Conventional Physical Therapy and Cervical Stabilization
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 42 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Jul 2026to 1 Sep 2027
- 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 20 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Male and female patients with unilateral SIS.
- Age is 20-40 years old.
- Presence of pain on anterolateral aspect of the shoulder for at least three months.
- At least 3 of the following criteria; positive Neer, Hawkins, and Empty can tests, Painful arc, and pain during resisted isometric abduction or external rotation.
Who cannot join
- Shoulder surgery, injury and arthritis.
- Any anatomical anomalies as hooked acromion.
- Cervical radiculopathy.
- Other systemic diseases: cardiovascular diseases, respiratory diseases and neurological diseases.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site
The Outpatient Clinic of the Faculty of Physical Therapy, Cairo University.
Giza, 11432
Mona M Ibrahim, Doctoral Degree, +201112339609, monamonir93@yahoo.com
Karima A Hassan, Assistant professor, +201114032967, Karima.abdelaty@pt.cu.edu.eg
About this study
Official title: Efficacy Of Adding Cervical Stabilization Exercises To Conventional Physical Therapy In Subacromial Impingement Syndrome
The goal of this clinical trial study is to determine efficacy of adding cervical stabilization exercises (CSEs) to conventional physical therapy (PT) program on pain severity, shoulder function disability, kinesiophobia, shoulder range of motion (ROM), isometric muscle strength and upper limb (UL) functional activity in closed kinetic chain in patients with SIS. The main questions it aims to answer is:
What are the effects of adding cervical stabilization exercises to a conventional physical therapy program in the management of shoulder impingement syndrome? Researchers will compare two groups: one group will receive CSEs beside the conventional PT program to the another group will receive the conventional PT program.
Read the detailed description
Shoulder impingement syndrome is a mechanical compression of the subacromial structures; specifically the subacromial bursa, rotator cuff, and long head of biceps tendons in the subacromial space. There are painful arm motions and functional restrictions.
The treatment of SIS focuses on improving pain and upper limb (UL) functions. Conservative treatments are effective in stages I or II of SIS.
Conservative treatments include non-steroidal anti-inflammatory drugs, corticosteroid injections, and exercise therapy such as strengthening for RC, and scapular muscles, stretching , proprioceptive neuromuscular facilitation (PNF), range of motion (ROM), and scapular stabilization exercises.
Cervical stabilization exercises (CSEs) can improve cervical spine stability, flexibility, muscular strength and endurance, and joint position sense. Shoulder stability extends beyond the shoulder joint as the head, neck, and shoulder are interconnected through muscles, tendons, and fascia.
Alteration of spine alignment leads to change mechanics of the shoulder. Forward head posture (FHP) can cause abnormal scapular orientation (internal rotation, elevation, and anterior tilting), decrease shoulder muscle strength, ROM, and increase humeral head translations that may predispose an individual to SIS. Also, increase thoracic kyphosis may cause increase scapular anterior tipping and retraction.
Crucially, the proper action of key scapular muscles, like the trapezius, requires the correct orientation of the cervical spine. This stability is achieved by the deep neck flexors (DNFs)-specifically the longus capitis and longus colli- which act as essential stabilizers for maintaining proper posture of the head and neck. Delayed timing of DNFs was shown to compromise spinal control during upper extremity function. Also, increased DNFs strength can enhance electromyographic (EMG) activity of scapular muscles (SA, UT, and LT).
One possible mechanism to describe the effect of CSEs in reducing pain is that stimulation of mechanoreceptors, including the muscle spindle and proprioceptors of joints. Signals from these receptors cause the release of endogenous opioids and beta-endorphins from the pituitary gland. Another possible mechanism of pain improvement is that the effect of these exercises in improving the coordination between the recruitment of the superficial and deep neck muscles. However, up to authors' knowledge, studies investigating the specific effects of adding CSEs to conventional SIS treatment are insufficient.
- Conditions
- Subacromial Impingement Syndrome, Pain
- Being tested
- Conventional Physical Therapy, Cervical Stabilization
- Keywords
- Subacromial impingement syndrome, Rotator cuff tendenitis, shoulder impingement syndrome, supraspinatus tendenitis
- Medical subject headings
- Shoulder Impingement Syndrome, Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Conventional Physical TherapyOther
- Rotator Cuff Strengthening Exercise: (Full Can Exercise, External Rotation Exercise, and Internal Rotation Exercise).
- Scapular Stabilization Exercise: (Prone Extension Exercise, Prone Horizontal Abduction with External Rotation Exercise, Prone Elevation Exercise, and Serratus Anterior Supine Punch ).
- Stretching Exercise: (Self-Sleeper Stretching for Posterior Capsule, Self-stretching for Pectoralis Minor, and Self-Stretching for Upper Trapezius:).
Intervention period will last for 6 weeks, 3 sessions per week. The duration of the session will be approximately forty minutes.
Cervical StabilizationOther
- Rotator Cuff Strengthening Exercise: (Full Can Exercise, External Rotation Exercise, and Internal Rotation Exercise).
- Scapular Stabilization Exercise: (Prone Extension Exercise, Prone Horizontal Abduction with External Rotation Exercise, Prone Elevation Exercise, and Serratus Anterior Supine Punch ).
- Stretching Exercise: (Self-Sleeper Stretching for Posterior Capsule, Self-stretching for Pectoralis Minor, and Self-Stretching for Upper Trapezius:).
- Cervical Stabilization Exercises: (Cranio-Cervical Flexion Exercise and Deep Cervical Extensors Exercise).
Intervention will be performed 3 times per week for 6 weeks. The duration of the session will be approximately one hour (40 min of conventional PT program and 15-20 min of CSEs with the progression).
| Study group | Role | What they receive |
|---|---|---|
| Control Group | Active comparator | Conventional Physical Therapy Program (Rotator Cuff Strengthening Exercise, Scapular Stabilization Exercise, and Stretching Exercise) Receives: Other: Conventional Physical Therapy |
| Experimental group | Active comparator | Cervical Stabilization Exercises (Deep Neck Flexors and Extensors) beside the Conventional PT Program. Receives: Other: Cervical Stabilization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain severity will be assessed by Visual Analog Scale
Visual Analog Scale consists of a 10 cm horizontal line anchored by "no pain" at one end and "worst pain imaginable" at the other end. The patient will elevate the arm to the available end- range then the patient will mark on the Visual Analog Scale the point that represents the pain severity during elevation. The score will be determined by measuring millimeters from the left-hand end of the line to the point that the patient marks.
Measured: Visual Analog Scale will be assessed before the intervention and then after the end of the intervention at 6 weeks.
Secondary outcomes (5)
Shoulder Disability will be assessed by shoulder pain and disability index
shoulder pain and disability index is a questionnaire that consists of two sections of 13 questions, one section for pain and the other for functional activities. The pain section forms of five questions regarding the severity of the patient's pain. Functional activities are evaluated with eight questions designed to measure the degree of difficulty the patient has with various activities of daily living, The patient will answer by placing a mark on a 10 cm visual analogue scale for each question. The score will be determined by measuring millimeters from the left-hand end of the line to the point that the patient marks. The scores from both dimensions are averaged to derive a total score.
The means of the two subscales will be averaged to produce a total score ranging from 0 (best) to 100 (worst).
Measured: Shoulder Pain and Disability Index will be assessed before the intervention and then after the end of the intervention at 6 weeks.
Kinesiophobia will be assessed by Tampa Scale of Kinesiophobia
Tampa Scale of Kinesiophobia is a self-report questionnaire consisting of 17 statements rated on a 4-point Likert scale (1=strongly disagree, 2= disagree, 3=agree, 4=strongly agree). The patient will answer each question of the tampa scale of Kinesiophobia through the 4-point likert scale to show how much fear of pain the patient feels. A total score will be calculated after inversion of the individual scores of items (4, 8, 12 and 16) and it can range from 17 (no kinesiophobia) to 68 (sever kinesiophobia.
Measured: Tampa Scale of Kinesiophobia will be assessed before the intervention and the after the end of the intervention at 6 weeks.
Shoulder range of motion by inclinometer
Inclinometer is a handheld device with high accuracy sensor used to measure the angular position of the body part relative to the horizontal or vertical planes.
Measured: Shoulder Range of Motion will be assessed before the intervention and then after the end of the intervention at 6 weeks.
Muscles strength will be assessed by Hand Held Dynamometer.
Hand Held Dynamometer is an instrument for measuring isometric muscles strength.
Measured: Muscles strength will be assessed before the intervention and then after the end of the intervention at 6 weeks.
Closed Kinetic Chain Upper Extremity Test
Closed Kinetic Chain Upper Extremity Test is a method that provides quantitative data for Upper limb functional activity in closed kinetic chain.
Males will perform the test by assuming a push-up position; while females by assuming a modified (kneeling) push-up position, both with back flat parallel to the floor and hands at 36-inches (90 cm) apart at the floor. Two parallel lines will be marked on the floor to determine the initial placement of the hands. Then, during 15 seconds, the subject will lean over one hand and will touch the opposite hand and then the hand will return to the starting position. Then the subject will perform the same movement with the other hand.
Measured: Closed Kinetic Chain Upper Extremity Test will be assessed before the intervention and then after the end of the intervention at 6 weeks.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jun 2026
- Study start1 Jul 2026 (estimated)
- Primary completion1 Jul 2027 (estimated)
- Study completion1 Sep 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Subacromial Impingement SyndromeStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- 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
- Participant
- Enrolment
- 42 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mona Monir Ibrahim Ahmed, Cairo University
- Investigators
- Mona M Ibrahim, Doctoral Degree, Principal investigator, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07645781
- Sponsor's protocol ID
- P.T.REC/012/006416
- Acronym
- CSEs in SIS
- Status last verified
- Jun 2026
- First submitted
- 9 Jun 2026
- Last updated
- 16 Jun 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 16 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Efficacy Of Adding Cervical Stabilization Exercises To Conventional Physical Therapy In Subacromial Impingement Syndrome
- ClinicalTrials.gov ID
- NCT07645781
- Acronym / sponsor ID
- CSEs in SIS / P.T.REC/012/006416
- Conditions
- Subacromial Impingement Syndrome, Pain
- Keywords
- Subacromial impingement syndrome, Rotator cuff tendenitis, shoulder impingement syndrome, supraspinatus tendenitis
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 42 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 1 Jul 2026 (estimated)
- Primary completion
- 1 Jul 2027 (estimated)
- Study completion
- 1 Sep 2027 (estimated)
- First posted
- 12 Jun 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.
The goal of this clinical trial study is to determine efficacy of adding cervical stabilization exercises (CSEs) to conventional physical therapy (PT) program on pain severity, shoulder function disability, kinesiophobia, shoulder range of motion (ROM), isometric muscle strength and upper limb (UL) functional activity in closed kinetic chain in patients with SIS. The main questions it aims to answer is:
What are the effects of adding cervical stabilization exercises to a conventional physical therapy program in the management of shoulder impingement syndrome? Researchers will compare two groups: one group will receive CSEs beside the conventional PT program to the another group will receive the conventional PT program.
Detailed description
Shoulder impingement syndrome is a mechanical compression of the subacromial structures; specifically the subacromial bursa, rotator cuff, and long head of biceps tendons in the subacromial space. There are painful arm motions and functional restrictions.
The treatment of SIS focuses on improving pain and upper limb (UL) functions. Conservative treatments are effective in stages I or II of SIS.
Conservative treatments include non-steroidal anti-inflammatory drugs, corticosteroid injections, and exercise therapy such as strengthening for RC, and scapular muscles, stretching , proprioceptive neuromuscular facilitation (PNF), range of motion (ROM), and scapular stabilization exercises.
Cervical stabilization exercises (CSEs) can improve cervical spine stability, flexibility, muscular strength and endurance, and joint position sense. Shoulder stability extends beyond the shoulder joint as the head, neck, and shoulder are interconnected through muscles, tendons, and fascia.
Alteration of spine alignment leads to change mechanics of the shoulder. Forward head posture (FHP) can cause abnormal scapular orientation (internal rotation, elevation, and anterior tilting), decrease shoulder muscle strength, ROM, and increase humeral head translations that may predispose an individual to SIS. Also, increase thoracic kyphosis may cause increase scapular anterior tipping and retraction.
Crucially, the proper action of key scapular muscles, like the trapezius, requires the correct orientation of the cervical spine. This stability is achieved by the deep neck flexors (DNFs)-specifically the longus capitis and longus colli- which act as essential stabilizers for maintaining proper posture of the head and neck. Delayed timing of DNFs was shown to compromise spinal control during upper extremity function. Also, increased DNFs strength can enhance electromyographic (EMG) activity of scapular muscles (SA, UT, and LT).
One possible mechanism to describe the effect of CSEs in reducing pain is that stimulation of mechanoreceptors, including the muscle spindle and proprioceptors of joints. Signals from these receptors cause the release of endogenous opioids and beta-endorphins from the pituitary gland. Another possible mechanism of pain improvement is that the effect of these exercises in improving the coordination between the recruitment of the superficial and deep neck muscles. However, up to authors' knowledge, studies investigating the specific effects of adding CSEs to conventional SIS treatment are insufficient.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Control Group | Active comparator | Other: Conventional Physical TherapyConventional Physical Therapy Program (Rotator Cuff Strengthening Exercise, Scapular Stabilization Exercise, and Stretching Exercise) |
| Experimental group | Active comparator | Other: Cervical StabilizationCervical Stabilization Exercises (Deep Neck Flexors and Extensors) beside the Conventional PT Program. |
Who may qualify
- Ages
- 20 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Male and female patients with unilateral SIS.
- Age is 20-40 years old.
- Presence of pain on anterolateral aspect of the shoulder for at least three months.
- At least 3 of the following criteria; positive Neer, Hawkins, and Empty can tests, Painful arc, and pain during resisted isometric abduction or external rotation.
Key exclusion criteria (4 listed)
- Shoulder surgery, injury and arthritis.
- Any anatomical anomalies as hooked acromion.
- Cervical radiculopathy.
- Other systemic diseases: cardiovascular diseases, respiratory diseases and neurological diseases.
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 |
|---|---|---|
| Conventional Physical Therapy* Rotator Cuff Strengthening Exercise: (Full Can Exercise, External Rotation Exercise, and Internal Rotation Exercise). * Scapular Stabilization Exercise: (Prone Extension Exercise, Prone Horizontal Abduction with External Rotation Exercise, Prone Elevation Exercise, and Serratus Anterior Supine Punch ). * Stretching Exercise: (Self-Sleeper Stretching for Posterior Capsule, Self-stretching for Pectoralis Minor, and Self-Stretching for Upper Trapezius:). Intervention period will last for 6 weeks, 3 sessions per week. The duration of the session will be approximately forty minutes. | Other | Control Group |
| Cervical Stabilization* Rotator Cuff Strengthening Exercise: (Full Can Exercise, External Rotation Exercise, and Internal Rotation Exercise). * Scapular Stabilization Exercise: (Prone Extension Exercise, Prone Horizontal Abduction with External Rotation Exercise, Prone Elevation Exercise, and Serratus Anterior Supine Punch ). * Stretching Exercise: (Self-Sleeper Stretching for Posterior Capsule, Self-stretching for Pectoralis Minor, and Self-Stretching for Upper Trapezius:). * Cervical Stabilization Exercises: (Cranio-Cervical Flexion Exercise and Deep Cervical Extensors Exercise). Intervention will be performed 3 times per week for 6 weeks. The duration of the session will be approximately one hour (40 min of conventional PT program and 15-20 min of CSEs with the progression). | Other | Experimental group |
Primary outcome
Pain severity will be assessed by Visual Analog Scale
Time frame: Visual Analog Scale will be assessed before the intervention and then after the end of the intervention at 6 weeks.
Visual Analog Scale consists of a 10 cm horizontal line anchored by "no pain" at one end and "worst pain imaginable" at the other end. The patient will elevate the arm to the available end- range then the patient will mark on the Visual Analog Scale the point that represents the pain severity during elevation. The score will be determined by measuring millimeters from the left-hand end of the line to the point that the patient marks.
5 secondary outcomes
Shoulder Disability will be assessed by shoulder pain and disability index
Time frame: Shoulder Pain and Disability Index will be assessed before the intervention and then after the end of the intervention at 6 weeks.
Kinesiophobia will be assessed by Tampa Scale of Kinesiophobia
Time frame: Tampa Scale of Kinesiophobia will be assessed before the intervention and the after the end of the intervention at 6 weeks.
Shoulder range of motion by inclinometer
Time frame: Shoulder Range of Motion will be assessed before the intervention and then after the end of the intervention at 6 weeks.
Muscles strength will be assessed by Hand Held Dynamometer.
Time frame: Muscles strength will be assessed before the intervention and then after the end of the intervention at 6 weeks.
Closed Kinetic Chain Upper Extremity Test
Time frame: Closed Kinetic Chain Upper Extremity Test will be assessed before the intervention and then after the end of the intervention at 6 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 16 Jun 2026.
- Individual participant dataSharing planned: No
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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.
Mona M Ibrahim, Doctoral Degree principal investigator
Cairo University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Conventional Physical Therapy and Cervical Stabilization in people with Subacromial Impingement Syndrome and Pain, run by Cairo University 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 4 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: opening soon, as of the sponsor's last update on 16 Jun 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 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?
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 Mona M Ibrahim, Doctoral Degree (+201112339609, monamonir93@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain severity will be assessed by Visual Analog Scale (time frame: Visual Analog Scale will be assessed before the intervention and then after the end of the intervention at 6 weeks.). 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 16 Jun 2026.