Manual Therapy Combined With Breathing

NCT ID: NCT07180225

Last Updated: 2025-09-18

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 52 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-02-10
• Study Completion Date: 2024-07-15

Brief Summary

Rotator cuff impingement syndrome is one of the most common causes of shoulder pain and functional limitation, with manual therapy frequently employed in its management. This study aimed to investigate the additional effects of incorporating breathing exercises into manual therapy on pain and function.

Detailed Description

Rotator cuff impingement syndrome is one of the most common causes of shoulder pain and functional limitation, with manual therapy frequently employed in its management. This study aimed to investigate the additional effects of incorporating breathing exercises into manual therapy on pain and function. The study was conducted with fifty-two individuals aged 18-65 diagnosed with rotator cuff impingement syndrome. Individuals who met the inclusion criteria were randomly and equally assigned to two groups. Participants in the control group received the cold pack, TENS, and conventional exercise program. Participants in the intervention group received manual therapy combined with respiratory exercises in addition to this therapy program. All participants received therapy three times a week for a total of six weeks. The Visual Analog Scale (VAS) and Shoulder Pain and Disability Index (SPADI), shoulder range of motion (ROM) assessments, and a spirometer were used for evaluation.

Conditions

Rotator Cuff Injuries

Study Design

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

Study Groups

GROUP I

Participants received conventional TENS applied to painful points in the shoulder region. Following TENS, patients performed a physiotherapist-supervised exercise program.At the beginning of the treatment, participants were provided with normal range of motion exercises and isometric strengthening exercises.Also, Glenohumeral joint (GH) distraction, glenohumeral joint inferior gliding, anterior gliding, and posterior gliding, scapulothoracic joint distraction, scapulothoracic joint superior, inferior, medial, and lateral gliding techniques were added.

Group Type: EXPERIMENTAL

Conventional therapy+manual therapy

Intervention Type: OTHER

Conventional therapy contains TENS and physiotherapist-supervised exercise program. These exercises are Wand exercises (15 repetitions each), codman exercises (1 minute in each direction), shoulder wheel exercises (5 minutes total), finger ladder exercises (10 repetitions), isometric exercises (10 repetitions each), capsular stretching exercises (10 repetitions each), pectoral muscle stretching and stabilization exercises (10 repetitions), shoulder stabilization exercises (5 minutes total), and strengthening exercises for the shoulder flexor, extensor, abductor, adductor, internal rotator, and external rotator muscles (15 repetitions each). In addition to them, manual therapy were applied to the shoulder region.

GROUP II

In addition to the treatment program applied in Group 1, participants in the intervention group received the following: Glenohumeral joint (GH) distraction, glenohumeral joint inferior gliding, anterior gliding, and posterior gliding, scapulothoracic joint distraction, scapulothoracic joint superior, inferior, medial, and lateral gliding, diaphragmatic breathing exercises, pursed-lip breathing exercises, and relaxation breathing exercises.

Group Type: EXPERIMENTAL

Conventional therapy+manual therapy+breathing exercises

Intervention Type: OTHER

In addition to the treatment program of Group I, breathing exercises were added. Each manual therapy technique was performed with 10 repetitions per participant. Similarly, participants were instructed to perform each breathing exercise with 10 repetitions. They were also asked to continue the breathing exercises at home, performing them three times a day with 10 repetitions per session for a duration of six weeks.

Interventions

Conventional therapy+manual therapy

Conventional therapy contains TENS and physiotherapist-supervised exercise program. These exercises are Wand exercises (15 repetitions each), codman exercises (1 minute in each direction), shoulder wheel exercises (5 minutes total), finger ladder exercises (10 repetitions), isometric exercises (10 repetitions each), capsular stretching exercises (10 repetitions each), pectoral muscle stretching and stabilization exercises (10 repetitions), shoulder stabilization exercises (5 minutes total), and strengthening exercises for the shoulder flexor, extensor, abductor, adductor, internal rotator, and external rotator muscles (15 repetitions each). In addition to them, manual therapy were applied to the shoulder region.

Intervention Type: OTHER

Conventional therapy+manual therapy+breathing exercises

In addition to the treatment program of Group I, breathing exercises were added. Each manual therapy technique was performed with 10 repetitions per participant. Similarly, participants were instructed to perform each breathing exercise with 10 repetitions. They were also asked to continue the breathing exercises at home, performing them three times a day with 10 repetitions per session for a duration of six weeks.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• being between 18 and 65 years of age;
• the presence of at least one of the following clinical findings: positive Neer Impingement Test, positive Hawkins-Kennedy Impingement test, or painful arc during active abduction or flexion
• experiencing pain in at least one of the resisted tests for internal rotation, external rotation, abduction, or flexion
• being able to participate in the face-to-face treatment program consisting of a total of 18 sessions

Exclusion Criteria

• a history of upper extremity fracture; undergoing shoulder surgery on the affected side within the past 12 months
• significant shoulder weakness or loss of active shoulder function; the presence of systemic musculoskeletal disorders
• symptom reproduction during active or passive cervical movements; the presence of consciousness disorders, cognitive impairments; and having any diagnosed cardiovascular disease

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Istanbul Medipol University Hospital

OTHER

Sponsor Role: lead

Responsible Party

merve yilmaz menek

Assoc. Prof

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

MERVE YILMAZ MENEK, PhD

Role: PRINCIPAL_INVESTIGATOR

İstanbul Medipol university

ŞULE AYAN

Role: PRINCIPAL_INVESTIGATOR

İstanbul Medipol university

Locations

Merve Yilmaz Menek

Istanbul, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

E-10840098-202.3.02-240-5

Identifier Type: -

Identifier Source: org_study_id