Mobilization With Movement in Rotator Cuff Tendinopathy
ConditionRotator Cuff Syndrome
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-65
SponsorKirsehir Ahi Evran Universitesi
About this trial
This randomized controlled trial aims to investigate the effects of Mobilization With Movement (MWM) combined with exercise therapy on tendon morphology, pain, and functional outcomes in individuals with rotator cuff tendinopathy. A total of approximately 60 participants diagnosed with supraspinatus tendinopathy will be randomly assigned to either an exercise-only group or an exercise plus MWM group.
All participants will undergo a standardized rehabilitation program for 8 weeks. Clinical outcomes, including pain intensity (Visual Analog Scale), shoulder function (SPADI and QuickDASH), range of motion, muscle strength, proprioception, and psychosocial status (Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale, and Central Sensitization Inventory), will be assessed at baseline and post-intervention. In addition, ultrasound imaging will be used to evaluate tendon morphology, including tendon thickness, subacromial bursa thickness, acromiohumeral distance, echogenicity, and vascularity.
The primary objective is to determine whether MWM produces superior improvements in clinical outcomes and whether it is associated with measurable changes in tendon structure as assessed by ultrasound. The findings are expected to contribute to a better understanding of the biomechanical and neurophysiological mechanisms underlying manual therapy in rotator cuff tendinopathy and to provide evidence for its role in musculoskeletal rehabilitation.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age between 18 and 65 years
Clinical diagnosis of rotator cuff tendinopathy (supraspinatus involvement) confirmed by musculoskeletal ultrasound
Shoulder pain duration of at least 3 months
Pain intensity ≥ 3/10 on the Visual Analog Scale (VAS)
Disqualifiers
Full-thickness or large rotator cuff tear confirmed by ultrasound or MRI
History of shoulder surgery on the affected side
Diagnosis of adhesive capsulitis (frozen shoulder)
Shoulder instability or dislocation history
Trial design
Design model
Parallel
Treatments tested in this trial
Exercise Therapy
BehavioralA standardized physiotherapy program including rotator cuff strengthening exercises, scapular stabilization exercises, posterior capsule stretching, pectoralis minor stretching, and active range of motion exercises for the shoulder.3 sessions per week for 8 weeks (supervised and/or home-based depending on protocol design)
Mobilization With Movement (MWM)
Procedure/SurgeryGlenohumeral joint Mobilization With Movement techniques (Mulligan concept), including posterior glide and inferior glide techniques applied during active shoulder movement, aimed at improving pain-free range of motion and function. Application Details: Grade: Sustained glide during active movement Techniques: Posterior glide, inferior glide Dosage: 2 sessions per week for 8 weeks Performed by licensed physiotherapist
Treatment groups
60 Participants
are divided into 2 treatment groupsGroup A: Exercise Only GroupActive comparator 1 intervention
Group B: Exercise + Mobilization With Movement (MWM) GroupExperimental treatment 2 interventions
Trial outcomes
Primary outcomes
1
Supraspinatus Tendon Thickness
Supraspinatus tendon thickness will be measured using musculoskeletal ultrasound imaging. Measurements will be obtained at the tendon footprint in the longitudinal plane using a high-frequency linear transducer. Tendon thickness will be recorded in millimeters (mm). This variable is selected as the primary structural outcome to evaluate morphological changes associated with the intervention. Increased or decreased tendon thickness will be interpreted in relation to clinical improvement and tissue remodeling.
Time frame
Baseline (Week 0) and post-intervention (Week 8)Secondary outcomes
1
Pain Intensity
Pain intensity will be assessed using a 10-cm Visual Analog Scale (VAS). Participants will rate their pain at rest, during activity, and at night. Scores range from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity.
Time frame
Baseline (Week 0) and post-intervention (Week 8)2
Shoulder Pain and Disability Index (SPADI)
SPADI will be used to evaluate shoulder pain and functional disability. The questionnaire consists of pain and disability subscales, with total scores ranging from 0 to 100. Higher scores indicate greater disability.
Time frame
Baseline (Week 0) and post-intervention (Week 8)3
QuickDASH Score
QuickDASH will assess upper limb disability and symptoms. It consists of 11 items scored from 1 to 5, converted to a scale from 0 to 100. Higher scores indicate greater functional limitation.
Time frame
Baseline (Week 0) and post-intervention (Week 8)4
Shoulder Range of Motion (ROM)
Active shoulder flexion, abduction, internal rotation, and external rotation will be measured using a goniometer or digital inclinometer in degrees.
Time frame
Baseline (Week 0) and post-intervention (Week 8)Locations
Sponsors and contacts
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Source ClinicalTrials.gov
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