Comparison of Manual Therapy Technique to Therapeutic Exercise in the Treatment of Patients With Subacromial Impingement Syndrome: A Randomized Clinical Trial

Zeynab Azin; Fahimeh Kamali; Nasrin Salehi Dehno; Sara Abolahrari-Shirazi

doi:10.1016/j.jmpt.2023.06.002

Comparison of Manual Therapy Technique to Therapeutic Exercise in the Treatment of Patients With Subacromial Impingement Syndrome: A Randomized Clinical Trial

J Manipulative Physiol Ther. 2023 Feb;46(2):98-108. doi: 10.1016/j.jmpt.2023.06.002. Epub 2023 Sep 29.

Authors

Zeynab Azin¹, Fahimeh Kamali², Nasrin Salehi Dehno³, Sara Abolahrari-Shirazi⁴

Affiliations

¹ Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
² Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
³ Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
⁴ Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: Sa_ahrari@yahoo.com.

PMID: 37777940
DOI: 10.1016/j.jmpt.2023.06.002

Abstract

Objective: The purpose of this study was to compare the effects of manual therapy to therapeutic exercise on shoulder pain, disability, and range of motion (ROM) in patients with subacromial impingement syndrome (SAIS).

Methods: Sixty patients with SAIS were randomly assigned into the manual therapy (MT) and therapeutic exercise (TE) groups. Patients in the MT group were treated with joint mobilization, which was applied to the glenohumeral, acromioclavicular, sternoclavicular and scapulothoracic joints, and trigger point (TrP) inactivation using ischemic compression. Patients in the TE group performed therapeutic exercises. Shoulder pain, disability and active ROM (elevation, external rotation, and internal rotation) were assessed by the visual analog scale, the Shoulder Pain and Disability Index, and a goniometer, respectively. The outcomes were measured at baseline, after the intervention, and 1 month after the intervention.

Results: After the treatment, both groups had significant improvements in shoulder pain, disability, and ROM (P < .05). The MT group experienced a greater reduction in shoulder pain than the TE group (P < .001). However, in disability and ROM, both groups exhibited similar improvements in post-treatment and follow-up periods.

Conclusion: Both MT and TE were effective in improving shoulder pain, disability, and ROM in patients with SAIS. Greater improvement in shoulder pain was observed in the MT group.

Keywords: Exercise; Musculoskeletal Manipulations; Shoulder; Trigger Points.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Exercise Therapy / methods
Humans
Musculoskeletal Manipulations* / methods
Physical Therapy Modalities
Range of Motion, Articular
Shoulder Impingement Syndrome* / therapy
Shoulder Pain / therapy
Treatment Outcome