Shoulder Impingement SyndromeSISNCT07800559
The Combined Effect of Thoracic Manipulation and Instrument-assisted Soft Tissue Mobilization in Patients With Shoulder Impingement Syndrome
A study testing conventional physical therapy, thoracic manibulation and instrument assisted soft tissue mobilization in people with Shoulder Impingement Syndrome, run by Cairo University.
Trial summary
This study will be conducted to investigate the combined effect of thoracic manipulation and instrument-assisted soft tissue mobilization in patients with shoulder impingement syndrome Read more about this study
- Who is it for?
- Ages 18 to 55 years
- Conditions the study is for
- Shoulder Impingement Syndrome
- What is being tested?
- conventional physical therapy, thoracic manibulation and instrument assisted soft tissue mobilization
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 80 participants
- Where
- No sites listed yet
- Study dates
- 10 Sep 2026to 10 May 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 18 to 55 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Patients with shoulder impingement syndrome from both genders their age from 18-55 years.
- History of shoulder pain for one month.
- Positive Neer's impingement test and Hawkin's Kennedy test.
- Painful arc sign.
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.
- Inflammatory arthropathies (e.g., rheumatoid arthritis, ankylosing spondylitis).
- Fracture or malignancy in the shoulder region
- Contraindications to manual therapy or thoracic manipulation (e.g., osteoporosis, spinal cord compression, vertebral artery insufficiency).
- Contraindications to IASTM (e.g., open wounds, skin infections, bleeding disorders, anticoagulant therapy).
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
This study will be conducted to investigate the combined effect of thoracic manipulation and instrument-assisted soft tissue mobilization in patients with shoulder impingement syndrome
Read the detailed description
Shoulder impingement syndrome (SIS) represents one of the most prevalent musculoskeletal disorders affecting the upper extremity, accounting for 44-65% of all shoulder complaints in clinical practice. The condition is characterized by mechanical compression of the rotator cuff tendons and subacromial bursa beneath the coracoacromial arch during arm elevation, resulting in pain, inflammation, and reduced quality of life. Thoracic spinal manipulation aims to restore mobility and optimize scapular positioning. Studies have shown that adding Maitland thoracic manipulation or Mulligan SNAGs to exercise leads to superior improvements in pain and range of motion.Thoracic spine manipulation (TSM) is one of the techniques that can be used to gain thoracic mobility in peoples with shoulder dysfunction Instrument-assisted soft tissue mobilization (IASTM) uses specialized tools to treat myofascial restrictions. It triggers a localized inflammatory response that initiates healing and remodeling. While promising in tendinopathy cases, there is a significant evidence gap regarding its efficacy when combined with joint-based manual therapy for SIS. Investigating the synergistic effects of combining these regional and local interventions with foundational scapular stabilization exercises will provide a comprehensive, evidence-based framework that is currently lacking in the literature.
- Conditions
- Shoulder Impingement Syndrome
- Being tested
- conventional physical therapy, thoracic manibulation, instrument assisted soft tissue mobilization, thoracic manipulation and instrument-assisted soft tissue mobilization
- Keywords
- Thoracic Manipulation, Instrument-assisted Soft Tissue Mobilization, Shoulder Impingement Syndrome
- 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.
conventional physical therapyOther
the patients will receive conventional physical therapy in the form of transcutaneous electrical nerve stimulation, ultrasound, and therapeutic exercise. The exercise includes range of motion exercises, stretching, scapular stabilization exercises, and rotator cuff strengthening.
thoracic manibulationOther
With the participant in a prone position, the therapist will apply a high-velocity, short-lever, posterior-to-anterior (P-A) thrust. The thrust will be directed toward the spinous or transverse processes of the hypomobile thoracic vertebrae. Thoracic thrust manipulation demonstrated to manipulate specific thoracic segment mainly the mid-thoracic, plus conventional physical therapy.
instrument assisted soft tissue mobilizationOther
The IASTM technique will be 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° angle to the skin. The beveled side of the M2T blade will be in contact with the skin. Stroke pressure and speed will be modified according to the participant's tolerance to avoid causing pain and according to the depth of the treated muscle plus conventional physical therapy.The technique will be applied to the pectoral muscles, shoulder rotator cuff musculature, and periscapular musculature, including the upper, middle, and lower fibers of the trapezius, rhomboids major and minor, teres major, and latissimus dorsi
thoracic manipulation and instrument-assisted soft tissue mobilizationOther
the patients will receive The IASTM technique will be 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° angle to the skin plus thoracic manibulation in which the therapist will apply a high-velocity, short-lever, posterior-to-anterior (P-A) thrust. The thrust will be directed toward the spinous or transverse processes of the hypomobile thoracic vertebrae. Thoracic thrust manipulation demonstrated to manipulate specific thoracic segments, mainly the mid-thoracic, plus conventional physical therapy. finally, the pateitns will recieve conventional physical therapy
| Study group | Role | What they receive |
|---|---|---|
| conventional physical therapy | Active comparator | Twenty patients with shoulder impingement syndrome will receive conventional physical therapy three times per week for 6 weeks Receives: Other: conventional physical therapy |
| thoracic manibulation | Experimental | twenty patients with shoulder impingement syndrome will receive thoracic manibulation plus conventional physical therapy three times per week for 6 weeks Receives: Other: conventional physical therapy; Other: thoracic manibulation |
| nstrument assisted soft tissue mobilization | Experimental | twenty patients with shoulder impingement syndrome will receive conventional physical therapy and instrument-assisted soft tissue mobilization three times per week for 6 weeks Receives: Other: conventional physical therapy; Other: instrument assisted soft tissue mobilization |
| thoracic manipulation and instrument-assisted soft tissue mobilization. | Experimental | twenty patients with shoulder impingement syndrome will receive thoracic manipulation + instrument-assisted soft tissue mobilization. The conventional physical therapy three times per week for 6 weeks Receives: Other: conventional physical therapy; Other: thoracic manibulation; Other: instrument assisted soft tissue mobilization; Other: thoracic manipulation and instrument-assisted soft tissue mobilization |
What is being measured
The primary outcome is the main question the study is designed to answer.
upper limb disability
Disabilities of the arm, shoulder and hand (Quick DASH) questionnaire will be used toassess upper limb diability.the QuickDASH only contains 11 items .It is a questionnaire that measures an individual's ability to complete tasks, absorb forces, and severity of symptoms.The QuickDASH tool uses a 5-point Likert scale from which the patient can select an appropriate number corresponding to his/her severity/function level.The QuickDASH outcome measure is designed to be used on patients presenting with one or more disabilities of the arm, shoulder, and hand. Scoring with 100 is more severe disability, and zero mean no disability.
Measured: up to six weeks
Secondary outcomes (5)
pain intensity
neumerical pain rating scale will be used to assess pain. 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 from 0-10 cm marked in 1 cm increments where 0 cm represents no pain and 10 cm the most severe pain imaginable
Measured: up to 6 weeks
shoulder range of motion
The Digital goniometer will be used to assess shoulder range of motion.
Measured: up to six weeks
shoulder proprioception (joint position error)
shoulder joint position error will be assessed by a smartphone clinometer application. Proprioception test was done by moving the participant's arms from the starting position (0 degrees) to the target angles. The arm remained at each target angle for 5 seconds, allowing the subjects to memorize the position before returning to the starting position. Subsequently, the subjects were instructed to independently move their arms towards each target angle.
Measured: up to six weeks
life disability
World Health Organization Quality of Life BREF will be used to assess life disability. The WHOQOL-BREF is a 26-item instrument that assesses quality of life across four domains: physical health (items 3, 4, 10, 15, 16, 17, and 18), psychological health (items 5, 6, 7, 11, 19, and 26), social relationships (items 20, 21, and 22), and environment (items 8, 9, 12, 13, 14, 23, 24, and 25). Items 1 and 2 assess overall quality of life and general health, respectively. Each item is rated on a 5-point Likert scale from 1 to 5. Items 3 and 4 are reverse-scored. For each domain, the item scores are averaged and multiplied by 4, producing a domain score ranging from 4 to 20, with higher scores indicating better quality of life.
Measured: up to six weeks
pressure pain threshold
pressure pain threshold wil be assessed by algometer.During the assessment, the patient is instructed to indicate the exact moment the sensation transitions from comfortable pressure to the onset of pain, effectively translating a subjective experience into an objective, measurable value (typically recorded in kg/cm² or Newtons).
Measured: up to six weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Sep 2026
- Study start10 Sep 2026 (estimated)
- Primary completion10 May 2027 (estimated)
- Study completion10 May 2027 (estimated)
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.
- 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
- Model description
- Thoracic Manipulation and Instrument-assisted Soft Tissue Mobilization
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 80 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Nabil Mahmoud Ismail Abdel-Aal, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07800559
- Sponsor's protocol ID
- P.T.REC/012/006555
- Acronym
- SIS
- Status last verified
- Aug 2026
- First submitted
- 29 Aug 2026
- Last updated
- 2 Sep 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 2 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Combined Effect of Thoracic Manipulation and Instrument-assisted Soft Tissue Mobilization in Patients With Shoulder Impingement Syndrome
- ClinicalTrials.gov ID
- NCT07800559
- Acronym / sponsor ID
- SIS / P.T.REC/012/006555
- Conditions
- Shoulder Impingement Syndrome
- Keywords
- Thoracic Manipulation, Instrument-assisted Soft Tissue Mobilization, Shoulder Impingement Syndrome
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 80 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 10 Sep 2026 (estimated)
- Primary completion
- 10 May 2027 (estimated)
- Study completion
- 10 May 2027 (estimated)
- First posted
- 2 Sep 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.
This study will be conducted to investigate the combined effect of thoracic manipulation and instrument-assisted soft tissue mobilization in patients with shoulder impingement syndrome
Detailed description
Shoulder impingement syndrome (SIS) represents one of the most prevalent musculoskeletal disorders affecting the upper extremity, accounting for 44-65% of all shoulder complaints in clinical practice. The condition is characterized by mechanical compression of the rotator cuff tendons and subacromial bursa beneath the coracoacromial arch during arm elevation, resulting in pain, inflammation, and reduced quality of life. Thoracic spinal manipulation aims to restore mobility and optimize scapular positioning. Studies have shown that adding Maitland thoracic manipulation or Mulligan SNAGs to exercise leads to superior improvements in pain and range of motion.Thoracic spine manipulation (TSM) is one of the techniques that can be used to gain thoracic mobility in peoples with shoulder dysfunction Instrument-assisted soft tissue mobilization (IASTM) uses specialized tools to treat myofascial restrictions. It triggers a localized inflammatory response that initiates healing and remodeling. While promising in tendinopathy cases, there is a significant evidence gap regarding its efficacy when combined with joint-based manual therapy for SIS. Investigating the synergistic effects of combining these regional and local interventions with foundational scapular stabilization exercises will provide a comprehensive, evidence-based framework that is currently lacking in the literature.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 4
- Model description
- Thoracic Manipulation and Instrument-assisted Soft Tissue Mobilization
| Arm | Type | Receives |
|---|---|---|
| conventional physical therapy | Active comparator | Other: conventional physical therapyTwenty patients with shoulder impingement syndrome will receive conventional physical therapy three times per week for 6 weeks |
| thoracic manibulation | Experimental | Other: conventional physical therapy, Other: thoracic manibulationtwenty patients with shoulder impingement syndrome will receive thoracic manibulation plus conventional physical therapy three times per week for 6 weeks |
| nstrument assisted soft tissue mobilization | Experimental | Other: conventional physical therapy, Other: instrument assisted soft tissue mobilizationtwenty patients with shoulder impingement syndrome will receive conventional physical therapy and instrument-assisted soft tissue mobilization three times per week for 6 weeks |
| thoracic manipulation and instrument-assisted soft tissue mobilization. | Experimental | Other: conventional physical therapy, Other: thoracic manibulation, Other: instrument assisted soft tissue mobilization, Other: thoracic manipulation and instrument-assisted soft tissue mobilizationtwenty patients with shoulder impingement syndrome will receive thoracic manipulation + instrument-assisted soft tissue mobilization. The conventional physical therapy three times per week for 6 weeks |
Who may qualify
- Ages
- 18 to 55 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Patients with shoulder impingement syndrome from both genders their age from 18-55 years.
- History of shoulder pain for one month.
- Positive Neer's impingement test and Hawkin's Kennedy test.
- Painful arc sign.
Key exclusion criteria (8 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.
- Inflammatory arthropathies (e.g., rheumatoid arthritis, ankylosing spondylitis).
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 therapythe patients will receive conventional physical therapy in the form of transcutaneous electrical nerve stimulation, ultrasound, and therapeutic exercise. The exercise includes range of motion exercises, stretching, scapular stabilization exercises, and rotator cuff strengthening. | Other | conventional physical therapy, nstrument assisted soft tissue mobilization, thoracic manibulation, thoracic manipulation and instrument-assisted soft tissue mobilization. |
| thoracic manibulationWith the participant in a prone position, the therapist will apply a high-velocity, short-lever, posterior-to-anterior (P-A) thrust. The thrust will be directed toward the spinous or transverse processes of the hypomobile thoracic vertebrae. Thoracic thrust manipulation demonstrated to manipulate specific thoracic segment mainly the mid-thoracic, plus conventional physical therapy. | Other | thoracic manibulation, thoracic manipulation and instrument-assisted soft tissue mobilization. |
| instrument assisted soft tissue mobilizationThe IASTM technique will be 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° angle to the skin. The beveled side of the M2T blade will be in contact with the skin. Stroke pressure and speed will be modified according to the participant's tolerance to avoid causing pain and according to the depth of the treated muscle plus conventional physical therapy.The technique will be applied to the pectoral muscles, shoulder rotator cuff musculature, and periscapular musculature, including the upper, middle, and lower fibers of the trapezius, rhomboids major and minor, teres major, and latissimus dorsi | Other | nstrument assisted soft tissue mobilization, thoracic manipulation and instrument-assisted soft tissue mobilization. |
| thoracic manipulation and instrument-assisted soft tissue mobilizationthe patients will receive The IASTM technique will be 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° angle to the skin plus thoracic manibulation in which the therapist will apply a high-velocity, short-lever, posterior-to-anterior (P-A) thrust. The thrust will be directed toward the spinous or transverse processes of the hypomobile thoracic vertebrae. Thoracic thrust manipulation demonstrated to manipulate specific thoracic segments, mainly the mid-thoracic, plus conventional physical therapy. finally, the pateitns will recieve conventional physical therapy | Other | thoracic manipulation and instrument-assisted soft tissue mobilization. |
Primary outcome
upper limb disability
Time frame: up to six weeks
Disabilities of the arm, shoulder and hand (Quick DASH) questionnaire will be used toassess upper limb diability.the QuickDASH only contains 11 items .It is a questionnaire that measures an individual's ability to complete tasks, absorb forces, and severity of symptoms.The QuickDASH tool uses a 5-point Likert scale from which the patient can select an appropriate number corresponding to his/her severity/function level.The QuickDASH outcome measure is designed to be used on patients presenting with one or more disabilities of the arm, shoulder, and hand. Scoring with 100 is more severe disability, and zero mean no disability.
5 secondary outcomes
pain intensity
Time frame: up to 6 weeks
shoulder range of motion
Time frame: up to six weeks
shoulder proprioception (joint position error)
Time frame: up to six weeks
life disability
Time frame: up to six weeks
pressure pain threshold
Time frame: up to six 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 2 Sep 2026.
Related trials for Shoulder Impingement Syndrome
Not yet recruiting
TECAR With Shoulder Chronic Shoulder Impingement Syndrome
Shoulder Impingement Syndrome
Recruiting
Device-Assisted Balance Training for People With Shoulder Impingement
Shoulder
Not yet recruiting
"Effectiveness of a Telerehabilitation Program Versus a Conventional Rehabilitation Program in Patients With Subacromial Pain"
Subacromial Impingement Syndrome
Active, not recruitingObservational study
Natural History of Shoulder Pathology in Manual Wheelchair Users
Paraplegia, Spinal Cord Injuries
Not yet recruiting
Spencer vs Positional Release Techniques for Chronic Subacromial Impingement
Chronic Subacromial Impingement Syndrome
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.
Questions about this trial
What is this clinical trial studying?
A study testing conventional physical therapy, thoracic manibulation and instrument assisted soft tissue mobilization in people with Shoulder Impingement Syndrome, run by Cairo University.
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 8 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 2 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
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 Nabil mahmoud, professor (+20 12 00133613, nabil.mahmoud@cu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
upper limb disability (time frame: up to six 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 2 Sep 2026.