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Subacromial impingement syndrome is a common musculoskeletal disorder. Therefore, to improve the shoulder biomechanics affected by the syndrome, an intervention group was compared with a control group. The exercise program applied to the intervention group is expected to improve the function of the shoulder complex.
Subacromial Impingement Syndrome (SIS) is one of the most common musculoskeletal problems in the shoulder joint. This study aimed to investigate the effectiveness of a rehabilitation program targeting humeral head depressor muscles on symptoms in individuals with SIS.Participants were randomly divided into study and control groups.Volunteers who complained of shoulder pain for more than a month, who had limitation in passive movement compared to the other side shoulder, who had Neer impingement test, Hawkins test, Jobe supraspinatus test, and who were able to com-municate were included in the study. Individuals 1) Having any neurological condition affecting the upper extremity, 2) having neurological findings related to cervical disc herniation, 3) having a full-thickness rupture of one of the rotator cuff tendons, 4) having calcific tendonitis, 5) having undergone previous shoulder surgery and 6) Physical therapy-rehabilitation for the shoulder with the same complaints in the last 6 months, or 7) receiving corticosteroid injection were excluded from the study. While the control group received standard physical therapy and rehabilitation, the study group underwent a progressive resistance exercise program to strengthen the humeral head depressors and peri-articular muscles, including the rotator cuff. Acromio-humeral distance (AHD) and tendon thickness measurements were evaluated by ultrasonography, while pain intensity was measured through VAS and McGill Questionnaire, upper extremity disability through DASH-T, and kinesiophobia through Fear Avoidance Beliefs Questionnaire, respectively.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| The Intervention Group | Experimental | The Intervention group underwent a progressive resistance exercise program to strengthen the humeral head depressors and peri-articular muscles, including the rotator cuff. The exercises were performed 3 times per week for 6 weeks, with each session lasting approximately 1 hour |
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| The Control Group | Active Comparator | Participants in the control group received standard physical therapy and rehabilitation as usually applied in routine care. Sessions were performed 3 times per week for 6 weeks, each lasting approximately 1 hour. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Humeral Head Depressor Exercises | Behavioral | The Intervention group underwent a progressive resistance exercise program to strengthen the humeral head depressors and peri-articular muscles, including the rotator cuff. Exercises were performed 3 times per week for 6 weeks, each session lasting approximately 1 hour |
| Measure | Description | Time Frame |
|---|---|---|
| Acromio-humeral Distance (Ultrasonography, USG) | Baseline and 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Tendon Thickness Measurment | Supraspinatus Tendon, Infraspinatus Tendon, subscapularis Tendon, Teres Minor Tendon, Long Head Biceps Tendon, Rotator Cuff group Tendons General Thicknesses were evaluated in all planes, by USG using a GE LogiqP6 Pro device and a linear transducer. Imaging was performed using standard shoulder sections while the patients were in a sitting position | Baseline and 6 week |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ahmet OZGUL, Prof. | Department of Physical Medicine and Rehabilitation, Kyrenia University Hospital, Kyrenia, Cyprus | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Near East University Hospital | Nicosia | Cyprus |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41303896 | Derived | Kurtaran U, Yerlikaya T, Yenen B, Ozgul A. The Effect of Humeral Head Depressor Strengthening on Individuals with Subacromial Impingement Syndrome. Medicina (Kaunas). 2025 Nov 19;61(11):2061. doi: 10.3390/medicina61112061. |
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The individual participant data from this study will not be shared.
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| ID | Term |
|---|---|
| D019534 | Shoulder Impingement Syndrome |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D000070599 | Shoulder Injuries |
| D014947 | Wounds and Injuries |
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Participants were quasi-randomly and sequentially assigned to either an intervention group receiving humeral head depressor exercises or a control group receiving routine exercise therapy. Each group followed their respective program for the duration of the study.
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Participants were blinded to their group assignment, but therapist were aware of the group allocations
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| Standard physical therapy | Behavioral | Participants in this group received standard physical therapy and rehabilitation as usually applied in routine care. Exercises were performed 3 times per week for 6 weeks, each session lasting approximately 1 hour. Outcomes were measured at the same time points as the intervention group. |
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| Pain (Visual Analog Scale, VAS) | Pain intensity will be assessed using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity. | Baseline and 6 weeks |
| Pain (McGill Pain Questionnaire-Pain Rating Index) | Pain will be assessed using the McGill Pain Questionnaire, specifically the Pain Rating Index (PRI). The total score ranges from 0 to 78, with higher scores indicating more severe pain. | Baseline and 6 weeks |
| Kinesiophobia (Fear Avoidance Beliefs Questionnaire - FABQ, Physical Activity subscale) | Kinesiophobia will be assessed using the Fear Avoidance Beliefs Questionnaire (FABQ) - Physical Activity subscale (items 2-5). Score range: 0 to 24 (higher scores indicate greater fear-avoidance beliefs related to physical activity). Time Frame: Baseline and 6 weeks. | Baseline and 6 weeks |
| Kinesiophobia (Fear Avoidance Beliefs Questionnaire - FABQ, Work subscale) | Kinesiophobia will also be assessed using the FABQ - Work subscale (items 6, 7, 9-12, 15). Score range: 0 to 42 (higher scores indicate greater fear-avoidance beliefs related to work). | Baseline and 6 weeks. |
| Upper Extremity Disability Through (DASH-T) | Baseline and 6 weeks |