Effect of Scapular Stabilization Exercises on Pain and Functional Outcomes in Subacromial Impingement Syndrome: A Randomized Controlled Trial

NCT07277868 — Not applicable, Completed, 60 participants, Kanuni Sultan Suleyman Training and Research Hospital

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Effect of Scapular Stabilization Exercises on Functional Outcomes in the Treatment of Subacromial Impingement Syndrome: A Controlled Clinical Study

Registry	NCT07277868
Status	Completed
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: none, treatment
Enrollment	60 (Actual)
Sponsor	Kanuni Sultan Suleyman Training and Research Hospital (Other)
Conditions	Subacromial Impingement Syndrome
Interventions	Standard Physiotherapy (Other)
Dates	start 2025-08-30, primary completion 2025-11-30, completion 2025-12-30, first posted 2025-12-11, last updated 2026-01-13
Locations	1 site in Turkey (Türkiye)

-Summary

This randomized controlled study aims to evaluate the effects of scapular stabilization exercises on pain, shoulder function, and quality of life in patients with subacromial impingement syndrome. Participants will be randomly assigned to either a scapular stabilization exercise program or a conventional shoulder rehabilitation program. Pain, functional outcome measures, and patient-reported quality of life will be assessed at baseline, 4 weeks, and 12 weeks. The study seeks to determine whether adding scapular stabilization exercises provides superior clinical benefit.

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+Detailed description

Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain and functional limitation. Scapular dyskinesis plays a key role in the development and persistence of SIS by altering scapulohumeral rhythm and increasing mechanical stress on subacromial tissues. Scapular stabilization exercises are increasingly used to restore normal scapular mechanics, improve muscular control, and reduce pain, but the clinical effectiveness of these exercises compared to conventional rehabilitation programs remains unclear.

This prospective, single-blind randomized controlled study investigates the effects of a scapular stabilization exercise program on pain, functional outcomes, and quality of life in patients diagnosed with SIS. Participants are randomly allocated to either a scapular stabilization group or a conventional shoulder rehabilitation group. Pain (VAS), functional status (QuickDASH and SPADI), range of motion, and quality-of-life measures are assessed at baseline, 4 weeks, and 12 weeks. The study aims to determine whether adding scapular stabilization exercises to standard rehabilitation leads to superior clinical improvement compared to conventional therapy alone.

+Arms and interventions

Arm	Type	Interventions	Description
Standard Physiotherapy	Active comparator	Other: Standard Physiotherapy	Participants in this arm receive standard physiotherapy consisting of electrotherapy, range-of-motion exercises, and stretching. The program is administered three times per week for 12 weeks. No scapular-specific stabilization or mobilization exercises are included. All participants also receive a home exercise program for daily stretching and mobility exercises.
Scapular Stabilization + Mobilization-Based Rehabilitation	Experimental	Other: Standard Physiotherapy	Participants receive the same standard physiotherapy as the control group, combined with a supervised scapular stabilization and mobilization-based rehabilitation program. This structured 12-week protocol (3 sessions per week) includes passive scapular mobilization (10-12 minutes per session) and a three-phase stabilization exercise progression targeting scapular mechanics, muscle activation, strength, and neuromuscular control. A daily home exercise program is also provided.

Standard Physiotherapy (Other), also known as Conventional Physiotherapy, Routine Physiotherapy: Standard physiotherapy consisting of electrotherapy modalities, range-of-motion exercises, and stretching exercises. The program is administered three times per week for 12 weeks. The intervention does not include any scapular-specific stabilization or mobilization techniques. All participants receive a home exercise program including daily stretching and mobility exercises.

+Outcome measures

Primary outcomes

1. Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) Score [Baseline, Week 6, Week 12]: QuickDASH is an 11-item validated questionnaire that measures physical function and symptoms related to upper extremity disorders. Total scores range from 0 to 100, with higher scores indicating greater disability. The primary outcome is the change in QuickDASH score from baseline to Week 12.

Secondary outcomes

Modified Constant-Murley Score (CMS) [Baseline, Week 6, Week 12]: The Constant-Murley Score assesses shoulder pain (15 points), daily activities (20 points), range of motion (40 points), and strength (25 points). Total score ranges from 0 to 100, with higher scores indicating better function. The secondary outcome is the improvement in CMS over time.
Visual Analog Scale (VAS) [Baseline, Week 6, Week 12]: Pain intensity at rest is measured using a 10-cm Visual Analog Scale (0 = no pain, 10 = worst pain). The outcome represents the change in resting pain levels over time.

+Eligibility

Sex: All, ages: 18 Years to 65 Years

Inclusion Criteria:

* Adults aged 18 to 65 years.
* Clinically diagnosed subacromial impingement syndrome (SIS) based on:positive Neer test ,positive Hawkins-Kennedy test ,painful arc between 60°-120°,pain during resisted shoulder tests
* Symptoms present for at least 4 weeks.
* Ability to comply with a 12-week supervised rehabilitation program.
* Ability to provide written informed consent.

Exclusion Criteria:

* Previous shoulder surgery on the affected side.
* Presence of full-thickness rotator cuff tear confirmed by ultrasound imaging.
* Evidence of cervical radiculopathy or significant cervical spine pathology.
* Advanced glenohumeral or acromioclavicular osteoarthritis.
* History of inflammatory rheumatic diseases (e.g., rheumatoid arthritis, ankylosing spondylitis).
* Severe cardiopulmonary, neurological, or systemic conditions limiting physical activity.
* Recent shoulder fracture or dislocation (< 6 months).
* Participation in another structured shoulder rehabilitation program within the last 3 months.
* Pregnancy.
* Inability to understand or follow instructions required for the intervention or assessments.

+Locations (1)

Facility	City	Country	Status
Kanuni Sultan Süleyman Training and Research Hospital	Istanbul	Turkey (Türkiye)

+Publications

Results publication: Karakuzu Gungor Z, Tan MS. Effect of scapular stabilization and mobilization-based rehabilitation on pain and shoulder function in subacromial impingement syndrome: a randomized controlled trial. BMC Musculoskelet Disord. 2026 Apr 13;27(1):330. doi: 10.1186/s12891-026-09760-7. PMID 41975358

+Investigators

Zeynep Karakuzu Güngör, Principal investigator, Kanuni Sultan Süleyman Training and Research Hospital