Effect of Scapular Stabilization Exercises on Pain and Functional Outcomes in Subacromial Impingement Syndrome: A Randomized Controlled Trial

Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain and functional limitation. Scapular dyskinesis plays a key role in the development and persistence of SIS by altering scapulohumeral rhythm and increasing mechanical stress on subacromial tissues. Scapular stabilization exercises are increasingly used to restore normal scapular mechanics, improve muscular control, and reduce pain, but the clinical effectiveness of these exercises compared to conventional rehabilitation programs remains unclear.

This prospective, single-blind randomized controlled study investigates the effects of a scapular stabilization exercise program on pain, functional outcomes, and quality of life in patients diagnosed with SIS. Participants are randomly allocated to either a scapular stabilization group or a conventional shoulder rehabilitation group. Pain (VAS), functional status (QuickDASH and SPADI), range of motion, and quality-of-life measures are assessed at baseline, 4 weeks, and 12 weeks. The study aims to determine whether adding scapular stabilization exercises to standard rehabilitation leads to superior clinical improvement compared to conventional therapy alone.

Inclusion criteria

• Adults aged 18 to 65 years.
• Clinically diagnosed subacromial impingement syndrome (SIS) based on:positive Neer test ,positive Hawkins-Kennedy test ,painful arc between 60°-120°,pain during resisted shoulder tests
• Symptoms present for at least 4 weeks.
• Ability to comply with a 12-week supervised rehabilitation program.
• Ability to provide written informed consent.

Exclusion criteria

• Previous shoulder surgery on the affected side.
• Presence of full-thickness rotator cuff tear confirmed by ultrasound imaging.
• Evidence of cervical radiculopathy or significant cervical spine pathology.
• Advanced glenohumeral or acromioclavicular osteoarthritis.
• History of inflammatory rheumatic diseases (e.g., rheumatoid arthritis, ankylosing spondylitis).
• Severe cardiopulmonary, neurological, or systemic conditions limiting physical activity.
• Recent shoulder fracture or dislocation (< 6 months).
• Participation in another structured shoulder rehabilitation program within the last 3 months.
• Pregnancy.
• Inability to understand or follow instructions required for the intervention or assessments.