The Immediate Effect of Mulligan's Mobilization With Movement on Shoulder Girdle' Pain, Range of Motion and Muscle Activity, in Subjects With Shoulder Impingement Syndrome

NCT ID: NCT06953895

Last Updated: 2025-05-01

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 24 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-01-01
• Study Completion Date: 2023-07-31

Brief Summary

The aim of present study was to evaluate the immediate effect of Mulligan's mobilization with movement on shoulder girdle' pain, range of motion (ROM) and muscle activity, in subjects with shoulder impingement syndrome

Detailed Description

A randomized, single-blind, placebo-controlled clinical trial was conducted with a sample composed by twenty-four volunteers with SIS, divided in Mulligan's MWM and Placebo groups. Pain intensity in Neer impingement signal and Hawkins-Kennedy impingement test, pressure pain threshold (PPT) on the lateral aspect of shoulder, ROM of shoulder scaption until onset of pain, as well as the activity of trapezius (upper, middle and lower fibers) and serratus anterior muscles during this movement, were evaluated before and immediate (post-) intervention. The Mulligan's MWM group received a mobilization with movement technique in the glenohumeral joint (sustained posterolateral glide during shoulder scaption), while no effective intervention was performed in the Placebo group.

Conditions

Shoulder Impingement Syndrome

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Intervention group

The Mulligan's MWM group received mobilization with movement in the glenohumeral joint, as described by Mulligan. The participant was seated, and the physiotherapist was placed on the opposite side to the affected shoulder with the thenar eminence of one hand over the anterior aspect of the humeral head, and the other hand over the spine of the scapula posteriorly of the affected shoulder. The hand over the humeral head performed a posterolateral glide, while the other hand stabilized the scapula. This maneuver was sustained while the participant asked to raise the arm in scapular plan (as explained above) without pain. The physiotherapist previously determined the amount of posterolateral pressure which was the best to abolish the pain during shoulder scaption for each participant.

Group Type: EXPERIMENTAL

Mulligan's Mobilization With Movement

Intervention Type: PROCEDURE

The Mulligan's MWM group received mobilization with movement in the glenohumeral joint, as described by Mulligan. The participant was seated, and the physiotherapist was placed on the opposite side to the affected shoulder with the thenar eminence of one hand over the anterior aspect of the humeral head, and the other hand over the spine of the scapula posteriorly of the affected shoulder. The hand over the humeral head performed a posterolateral glide, while the other hand stabilized the scapula. This maneuver was sustained while the participant asked to raise the arm in scapular plan (as explained above) without pain. The physiotherapist previously determined the amount of posterolateral pressure which was the best to abolish the pain during shoulder scaption for each participant. The participants performed three sets of 10 trials with a resting time of 30 seconds between each set. After intervention was allowed a resting time of three minutes.

Placebo Group

In the Placebo group, no effective intervention was performed, the participant was asked to raise the affected arm in scapular plane without pain, while the physiotherapist placed their hands-on shoulder, with the same manual contacts described in Mulligan's MWM group, but without performing any pressure.

Group Type: PLACEBO_COMPARATOR

Active Mobilization

Intervention Type: PROCEDURE

In the Placebo group, no effective intervention was performed, the participant was asked to raise the affected arm in scapular plane without pain, while the physiotherapist placed their hands-on shoulder, with the same manual contacts described in Mulligan's MWM group, but without performing any pressure.

The participants performed three sets of 10 trials with a resting time of 30 seconds between each set. After intervention was allowed a resting time of three minutes.

Interventions

Mulligan's Mobilization With Movement

The Mulligan's MWM group received mobilization with movement in the glenohumeral joint, as described by Mulligan. The participant was seated, and the physiotherapist was placed on the opposite side to the affected shoulder with the thenar eminence of one hand over the anterior aspect of the humeral head, and the other hand over the spine of the scapula posteriorly of the affected shoulder. The hand over the humeral head performed a posterolateral glide, while the other hand stabilized the scapula. This maneuver was sustained while the participant asked to raise the arm in scapular plan (as explained above) without pain. The physiotherapist previously determined the amount of posterolateral pressure which was the best to abolish the pain during shoulder scaption for each participant. The participants performed three sets of 10 trials with a resting time of 30 seconds between each set. After intervention was allowed a resting time of three minutes.

Intervention Type: PROCEDURE

Active Mobilization

In the Placebo group, no effective intervention was performed, the participant was asked to raise the affected arm in scapular plane without pain, while the physiotherapist placed their hands-on shoulder, with the same manual contacts described in Mulligan's MWM group, but without performing any pressure.

The participants performed three sets of 10 trials with a resting time of 30 seconds between each set. After intervention was allowed a resting time of three minutes.

Intervention Type: PROCEDURE

Other Intervention Names

MWM

Eligibility Criteria

Inclusion Criteria

Participants had superolateral shoulder pain and two out of four specified objective signs and symptoms:

• positive Neer test;
• positive Hawkins-Kennedy test;
• painful limitation of active arm elevation (flexion, abduction, scaption);
• pain or limitation with functional movement patterns of hand behind back or hand behind head.

Exclusion Criteria

• physician diagnosis of adhesive capsulitis;
• grade III rotator cuff tear;
• calcific tendinosis confirmed by radiology;
• systemic or neurological disorder;
• cervical radiculopathy; a history of shoulder surgery;
• corticosteroid injection within the past month;
• subjects who had received physical therapy intervention for their shoulder within the past three months.

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Escola Superior de Tecnologia da Saúde do Porto

OTHER

Sponsor Role: lead

Responsible Party

Daniela Ferreira Carneiro

MSc

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

E2S | P.PORTO - Escola Superior de Saúde do Politécnico do Porto

Porto, Porto District, Portugal

Countries

Portugal

Other Identifiers

00853

Identifier Type: -

Identifier Source: org_study_id