Comparison of Supervised Rehabilitation and Home Exercise Programs in Subacromial Impingement Syndrome

Subacromial impingement syndrome (SAIS) is one of the most common causes of shoulder pain, leading to decreased range of motion, muscle weakness, functional limitations, and reduced quality of life. Exercise-based rehabilitation is considered a primary conservative treatment approach. However, access to supervised physiotherapy services may be limited due to long waiting times and healthcare system constraints. Home exercise programs may serve as an alternative, but evidence comparing their effectiveness with supervised rehabilitation remains limited.

This study is designed as a randomized controlled trial to compare the effectiveness of physiotherapist-supervised rehabilitation and home exercise programs in individuals with SAIS. A total of 63 participants who meet the inclusion criteria will be recruited and randomly assigned into three groups: supervised rehabilitation, home exercise, and control.

Randomization will be performed using an online randomization tool. Participants allocated to the supervised rehabilitation group will receive a structured rehabilitation program consisting of pain management modalities, range of motion exercises, strengthening exercises, and functional training under the supervision of a physiotherapist, five days per week for four weeks. The home exercise group will receive a structured exercise program including stretching, strengthening, and mobility exercises after a single training session and will continue the program independently at home. Participants in the control group will not receive any intervention during the study period and will be included in the supervised rehabilitation program after the final assessment.

Outcome measures will include pain intensity assessed by Visual Analog Scale, upper extremity function assessed by the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), shoulder range of motion measured by goniometer, grip strength measured by dynamometer, sleep quality assessed by a single-item sleep quality scale, and quality of life assessed by the WHOQOL-BREF. Assessments will be conducted at baseline and at the end of the 4-week intervention period.

The findings of this study will contribute to the literature by providing evidence on the comparative effectiveness of supervised rehabilitation and home-based exercise programs and may guide clinical decision-making in the management of SAIS.

Inclusion criteria

• Voluntary participation in the study
• Literate in Turkish
• Aged between 30 and 65 years
• No visual or hearing impairment
• Diagnosed with unilateral subacromial impingement syndrome by a specialist physician
• Positive painful arc test, Infraspinatus test, and Hawkins-Kennedy test
• Pain during overhead activities

Exclusion criteria

• Presence of a mental or psychological disorder that may affect study findings
• Inadequate cooperation
• History of upper extremity fracture within the last 6 months
• Presence of cervical neurological symptoms
• Glenohumeral instability
• Acromioclavicular joint pathology
• Full-thickness rotator cuff tear or total rupture
• Signs of glenohumeral osteoarthritis
• History of frozen shoulder