Manual Therapy Combined With Breathing Exercises in Management of Rotator Cuff Impingement Syndrome

Not Applicable

Completed

• Conditions: Rotator Cuff Syndrome

• Registration Number: NCT05584345
• Lead Sponsor: Istanbul Medipol University Hospital

Brief Summary

As it causes pain and disability in individuals with rotator cuff lesions, which is one of the most common causes of shoulder pain, it affects performance in activities of daily living. Shoulder pain significantly affects the quality of life of individuals. The aim of conventional treatment in Rotator Cuff injuries is to reduce the inflammation in the area and to enable the shoulder to perform its normal functions. Conventional treatment is to restore muscle balance in the shoulder area. Muscle balance is achieved by strengthening the teres minor, infraspinatus, and subscapularis, which are also the humeral head depressors, and by strengthening the serratus anterior, levator scapula. For strengthening, the shoulder must have a full range of motion. In our study, stretching exercises, cold pack, Ultrasound, TENS, wand, and Codman exercises, which are classical physiotherapy methods, will be applied to all three groups. There are also studies in the literature investigating the effects of traditional physiotherapy methods on individuals with shoulder Rotator Cuff syndrome. The benefits of breathing exercises on pain, shoulder joint range of motion, and balance have all been researched in the literature. Increased diaphragm activity also guarantees that posture and body positions are maintained healthily. Diaphragm activity generally alters how an individual perceives pain. Diaphragmatic breathing is a therapeutic approach for musculoskeletal disorders.

Detailed Description

Breathing techniques have been demonstrated to reduce shoulder pain and increase ROM at the literature. However, no study has been found on the effectiveness of breathing exercises applied in addition to conventional physiotherapy in individuals with Rotator Cuff syndrome.

Based on all of this knowledge, it was designed for this study to examine the efficacy of breathing exercises used in combination with traditional physiotherapy in patients with Rotator Cuff syndrome.

Study Timeline

• Study First Submitted: 2022-09-20
• Study First Submitted QC: 2022-10-17
• Study First Posted: 2022-10-18
• Study Start: 2022-10-30
• Primary Completion: 2023-07-03
• Study Completion: 2023-07-03
• Status Verified: 2025-09
• Last Update Submitted: 2025-09-05
• Last Update Posted: 2025-09-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 52

Inclusion Criteria

1. Restricted shoulder joint range of motion
2. Having Rotator Cuff Syndrome
3. Not having had any shoulder surgery
4. Being between the ages of 18 - 65

Exclusion Criteria

1. Major trauma to the shoulder
2. Anatomical deformities and skeletal system fractures
3. Diagnosed orthopedic or rheumatological diseases
4. Being included in a physiotherapy program in the last 6 months
5. Having a cardiac pacemaker
6. Presence of active infection
7. Myocardial infarction in the last 6 months
8. Participants who have any illness that prevents them from doing the exercises will be excluded from the study.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Visual Analog scale (VAS)	From enrollment to the end of treatment at six weeks	Pain intensity will be with VAS that is a tool commonly used to assess the intensity of musculoskeletal pain (18). The VAS will be used to evaluate the level of shoulder pain experienced by participants at rest, and during activity. Participants were asked to rate their pain intensity on a scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst possible pain." The participants' responses will be recorded in the case report forms.

Secondary Outcome Measures

Name	Time	Method
Goniometric Measurement	From enrollment to the end of treatment at six weeks	In our study, the degrees of flexion, extension, abduction, internal rotation, and external rotation of the affected shoulder will be measured by means of a universal goniometer. Flexion and abduction 0-180 degrees, extension 45 degrees, internal and external rotation 0-90 degrees will be taken as reference.
Shoulder Pain and Disability Index (SPADI)	From enrollment to the end of treatment at six weeks	Shoulder Pain and Disability Index (SPADI) is a self-reported, shoulder specific questionnaire developed to assess pain intensity and disability levels in individuals with musculoskeletal shoulder pain. The disability subscale includes eight items, where patients rate the difficulty, they experienced while performing daily activities in the past week, using a scale from 0 (no difficulty) to 10 (so difficult that assistance is required). The total SPADI score was calculated by converting the total raw score into a percentage. The final score ranges from 0 to 100, with higher scores indicating greater levels of pain and disability.

Trial Locations

Locations (1)

Istanbul Medipol University; Istanbul, Turkey (Türkiye)