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The aim of this randomized controlled trial is to investigate the acute effects of fascia correction Kinesio Taping applied to the thoracolumbar fascia (TLF) in individuals with Subacromial Impingement Syndrome (SIS). Participants will be randomly allocated into an intervention group and a sham taping control group. The intervention group will receive fascia correction Kinesio Taping applied to the thoracolumbar region, while the control group will receive sham taping without therapeutic effect. Clinical parameters including pain intensity, trunk range of motion, thoracolumbar fascia flexibility, lumbar mobility, and posterior shoulder capsule tightness will be assessed before the intervention and 45 minutes after the application. This study aims to provide evidence regarding the acute clinical effects of thoracolumbar fascia modulation in individuals with Subacromial Impingement Syndrome.
Subacromial Impingement Syndrome (SIS) is one of the most common causes of shoulder pain and is characterized by pain, movement limitation, and functional impairment. Contemporary biomechanical perspectives suggest that shoulder function is influenced not only by local anatomical structures but also by proximal structures such as the thorax, spine, and thoracolumbar fascia. The thoracolumbar fascia plays an important role in force transmission between the upper and lower extremities and contributes to postural control and movement coordination. Therefore, interventions targeting the thoracolumbar fascia may influence shoulder function and related clinical outcomes.
This randomized controlled trial will include a total of 60 participants diagnosed with Subacromial Impingement Syndrome. Participants will be randomly assigned into two groups: an intervention group receiving fascia correction Kinesio Taping using the Ram's Head technique applied to the thoracolumbar fascia, and a control group receiving sham Kinesio Taping without therapeutic fascia correction.
In the intervention group, Y-shaped Kinesio Tape will be applied to the thoracolumbar region using the fascia correction technique. Low-to-moderate tape tension (10-50%) combined with manual oscillatory movements will be used to facilitate fascial mobilization and modulate tissue glide capacity. The sham group will receive taping without therapeutic fascial correction.
Assessments will be performed immediately before the intervention and 45 minutes after tape application. Outcome measures will include pain intensity during rest and activity assessed using the Visual Analog Scale (VAS), trunk range of motion measured by goniometry, trunk flexibility assessed by tape measurements, thoracolumbar fascia flexibility evaluated using a goniometric platform, lumbar mobility assessed by the Modified Schober Test, and posterior shoulder capsule tightness measurement.
The primary aim of this study is to investigate the acute clinical effects of fascia correction Kinesio Taping applied to the thoracolumbar fascia in individuals with Subacromial Impingement Syndrome and to provide evidence regarding the potential effects of fascial modulation on pain, mobility, range of motion, and tissue flexibility.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Kinesio Taping Group | Active Comparator | Participants in this group will receive the "Ram's Horn" fascia correction technique using Kinesio Taping applied to the thoracolumbar fascia region. The base (anchor) of a Y-shaped kinesiology tape will be applied without tension between the lateral iliac crest and the axillary line. From this anchor point, the tape will be divided into two tails. The first tail will be directed superiorly over the scapular region and attached along the superior border of the scapula. The second tail will be directed inferiorly and posteriorly across the lumbar region toward the superior aspect of the iliac crest, creating a configuration resembling a ram's horn. During the application of both tape tails, oscillatory fascial correction movements will be performed manually by shifting the underlying fascia while the tape is applied. No tension will be applied to the anchor portion of the tape. The technique is intended to provide a fascial correction effect throughout the thoracolumbar region. |
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| control group | Sham Comparator | Participants in the sham group will receive a placebo taping application using a Y-shaped kinesiology tape. The tape will be applied without tension and without the oscillatory fascial correction maneuvers used in the Ram's Horn technique. The anchor will be placed near the axillary region, and both tails of the Y-shaped tape will be directed inferiorly toward the iliac crest in a random, non-corrective configuration. The tape will not be arranged in the characteristic ram's horn pattern and will be applied without any intended therapeutic fascial correction effect. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| kinesio taping | Other | Assessments will be performed immediately before the intervention and 45 minutes after tape application in both groups. Outcome measures will include pain intensity during rest and activity assessed using the Visual Analog Scale (VAS), trunk range of motion measured by goniometry, trunk flexibility assessed by tape measurements, thoracolumbar fascia flexibility evaluated using a goniometric platform, lumbar mobility assessed by the Modified Schober Test, and posterior shoulder capsule tightness. Participants in the intervention group will receive corrective kinesio taping applied in a horn-shaped configuration, whereas the sham group will receive a tension-free tape application from the lateral trunk/axillary region toward the hip without therapeutic fascial correction. |
| Measure | Description | Time Frame |
|---|---|---|
| thoracolumbar fascia flexibility | The flexibility of the thoracolumbar fascia was evaluated using a goniometric platform. A goniometric platform was placed on a table in front of the participants. Patients were asked to clasp their hands in front at 90° of shoulder flexion, holding a wooden marker between their hands. Patients performed maximum trunk rotation, first to the right and then to the left, while ensuring their arms followed the movement of the trunk. The rotation degree reached by the marker was recorded on the goniometric platform. The test was repeated three times for each direction with one-minute rest intervals, and the average values were recorded. A decrease in rotation range during repeated trials or restricted movement was considered indicative of TLF tightness. | 15 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| pain assessment, rest and active | Pain intensity was evaluated using a 10 cm VAS (0: no pain, 10: worst pain). Measurements were recorded at baseline and 45 minutes post-taping in two conditions: Resting Pain: Pain level while the participant was in a relaxed position. Activity Pain: Pain level during basic activities, such as arm movements and walking. The distance between the marked point and the zero point was measured in centimeters using a ruler |
| Measure | Description | Time Frame |
|---|---|---|
| Shoulder posterior capsule shortness: | Shoulder posterior capsule shortness was measured and evaluated with a tape measure. Participants were positioned in a side-lying position at the edge of the examination table. The scapula of the measured side was stabilized by the physiotherapist. The shoulder was moved into horizontal adduction and the arm was allowed to drop toward the table. The distance between the olecranon and the table surface was measured and recorded in centimeters |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| GÜL BALTACI, Prof. Dr. | Contact | +905323963279 | ygulbaltaci@gmail.com | |
| KÜBRA SARIOĞLU, PhD | Contact | +905369370561 | fztkubrasarioglu@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| KÜBRA SARIOĞLU, PhD | HACETTEPE ÜNİVERSİTESİ ,Anafartalar, Talatpaşa Blv No:47, 06100 Altındağ/Ankara | Principal Investigator |
| Gül Baltacı, Prof.Dr. | Atlas University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hacettepe Sporcu Sağlığı Ünitesi | Recruiting | Ankara | Altindag | 06100 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D019534 | Shoulder Impingement Syndrome |
| D020069 | Shoulder Pain |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D000070599 | Shoulder Injuries |
| D014947 | Wounds and Injuries |
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Two groups with subacromial impingement syndrome.
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The intervention group will receive fascia correction Kinesio Taping applied to the thoracolumbar region, while the control group will receive sham taping without therapeutic effect by a investigator who was blinded to group allocation.
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| 3 minutes |
| Modified schober test | The physiotherapist determined the SIPS with a pencil. The midpoint of the line connecting the Spina İliaca Posterior Superior (SIPS) is marked. The point 10 cm above and 5 cm below this point was determined with a tape measure. The person was asked to perform maximum trunk flexion. The distance between these two points was measured. The difference was less than 5 cm, indicating low back flexibility | 5 minutes |
| 5 minutes |
| Trunk Range of Motion: | The ROM values were evaluated using a goniometer. The results were recorded in degrees (°) for lateral flexion, flexion and extension directions | 5 minutes |
| Trunk flexibility | both sides rotation, lateral flexion and extension | 5 minutes |
| D018771 |
| Arthralgia |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |