Mulligan Mobilization Versus PNF Technique in SIS
ConditionSubacromial Impingement Syndrome
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age20-40
SponsorCairo University
About this trial
To investigate the differences between adding Mulligan mobilization and PNF to the conventional physical therapy program on shoulder pain, function, shoulder muscles strength, glenohumeral flexion, abduction, external rotation, and internal rotation ROM, scapular symmetry, and pectoralis minor length in patients with SIS.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Sixty nine Males and females subjects with SIS, age between 20-40 years old and body mass index (BMI) 18-27.9 kg/m2
The SIS group will be limited to patients who had history of shoulder pain of >1-week duration.
Pain localized at the proximal anterolateral shoulder region.
Patients with subacromial pain syndrome with positive results of 3 of 5 tests: painful arc, pain or weakness with resisted external rotation, Neer test, Hawkins Kennedy test, and Jobe/empty can test.
Disqualifiers
Open wounds, infection, acute injuries, swelling, rheumatoid arthritis, reflex sympathetic syndrome, or adhesive capsulitis.
BMI greater than 28 kg/m².
History of shoulder girdle fractures and dislocation, shoulder surgery in the last 12 months or full thickness rotator cuff tear.
History of systemic or neurological disorder, cervical radiculopathy and subjects who had received physical therapy treatment for their shoulder within the past three months.
Trial design
Design model
Parallel
Treatments tested in this trial
Standard conventional program
Other interventionPatients receive standard conventional program inform of exercise and TENS
Proprioceptive neuromuscular facilitation (PNF) +Standard program
Other interventionpatients receive Proprioceptive neuromuscular facilitation (PNF) +Standard conventionalprogram
MWM +Standard program
Other interventionpatients receive MWM +Standard program
Treatment groups
69 Participants
are divided into 3 treatment groupsGroup A: standard conventional ProgramActive comparator 1 intervention
Group B: PNF technique + same standard conventional programExperimental treatment 1 intervention
Group C: MWM+ same standard conventional programExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
The Shoulder Pain and Disability Index (SPADI)
assesses pain and disability in shoulder pathology. Patients answer five questions related to pain and eight questions related to function
Time frame
at baseline and after 6 weeks post intervention2
Shoulder ROM
the smartphone inclinometer will be used to perform clinical measurements of shoulder motion (Flexion, Abduction, External Rotation in 90- of Abduction, Internal Rotation in 90- of Abduction)
Time frame
at baseline and after 6 weeks post intervention3
The Timed Functional Arm and Shoulder Test (TFAST)
Task 1: Hand to Head and Back (HHB) 30s Movement: Move arm from the side to touch the back of the head (palm preferred), then move down to touch the small of the back with the back of the hand. Scoring: 1 rep per head touch. Task 2: Wall Wash (Inward/Outward) 60s per direction Movement: Move a towel in a 12-inch diameter circle at shoulder height, touching 4 drawn marks. Start at the top mark. Scoring: 1 rep each time the hand passes the top mark. Done clockwise and counter-clockwise. Task 3: Gallon-Jug Lift - 30s Movement: Lift a 3.78 kg jug from a 36-inch high counter to lightly tap a shelf 20 inches above it, then lower it without resting. Scoring: 1 rep per shelf tap. Total TFAST Score Calculation To equalize all tasks for a 30-second timeframe, the final score is calculated using this formula: \[HHB + (wall wash inward and outward/4) + gallon-jug lift\]
Time frame
at baseline and after 6 weeks post-interventionSecondary outcomes
1
Measuring isometric strength with Hand-held sphygmomanometer
A Hand-held sphygmomanometer (HHS) will been more commonly used to measure Internal and External rotation and shoulder scaption isometric strength
Time frame
at baseline and after 6 weeks post-intervention2
The Modified Lateral Scapular Slide test
Shoulder position will be visually estimated, and the distance from the inferior angle of the scapulae and the spinous process of T7 .will be measured using a tape measure or goniometer in 3 different arm positions: neutral, 45°, and 90° The first position was with the arms by the side. The second was with the subject's hands on the hips, and the third was with the arms elevated to 90° of shoulder abduction in scaption with maximal internal rotation and 1 kg load hold in their hands
Time frame
at baseline and after 6 weeks post-intervention3
Pectoralis minor length test
Subjects will lie supine, relaxed, with legs bent and arms at their sides in neutral rotation. An investigator will measure the vertical distance from the posterolateral acromion to the table in millimeters using a metal scale. A positive test, indicating pectoralis minor tightness, is defined as a distance greater than 2.54 cm (1 inch), while a negative test is a measurement less than or equal to 2.6 cm
Time frame
at baseline and after 6 weeks post-interventionSponsors and contacts
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Source ClinicalTrials.gov