Cervical Unilateral Antero-posterior Mobilization and Thoracic Central Postro-anterior Mobilization in Treatment of Shoulder Impingement Syndrome

This study will be conducted to answer the following question:

What is the effect of adding cervical and thoracic mobilization to selected therapeutic exercise Program on pain intensity, Pain-free shoulder flexion and scaption active ROM, muscle strength of external rotator and abductors, shoulder functional status in patients with Shoulder Impingement Syndrome

Inclusion criteria

required at least three positive findings from five diagnostic tests for SIS (Hawkins-Kennedy test, Neer's test, painful arc, Resisted External Rotation test, Jobe's test) and persistent shoulder pain (anterolateral shoulder region) for 3 to 6 months, along with limitations in functional movements as Individuals who experienced painful restrictions in their ability to raise their shoulder (flexion, abduction, scaption) and had pain or limitations when performing functional movements such as reaching behind their back or behind their head. As well as subjects who willingly participated in the study and gave their consent for the research purposes.

Exclusion criteria

included adhesive capsulitis, radiologically confirmed grade III rotator cuff tears, calcific tendinitis, neurological or systemic disorders, cervical radiculopathy, prior shoulder surgery, recent corticosteroid injections, or recent physiotherapy within the previous three months. Patients complain from shoulder pain without pain on palpation, mobility limitations or pain during provocative tests, but complaining of abdominal tenderness on palpation were also excluded from this study.