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Completed

NCT Number: NCT07228455

The Effect of Humeral Head Depressor Strengthening in Individuals With Subacromial Impingement Syndrome

Subacromial impingement syndrome is a common musculoskeletal disorder. Therefore, to improve the shoulder biomechanics affected by the syndrome, an intervention group was compared with a control group. The exercise program applied to the intervention group is expected to improve the function of the shoulder complex.

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Key information

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Near East University Hospital

Nicosia, Cyprus

About this study

Subacromial Impingement Syndrome (SIS) is one of the most common musculoskeletal problems in the shoulder joint. This study aimed to investigate the effectiveness of a rehabilitation program targeting humeral head depressor muscles on symptoms in individuals with SIS.Participants were randomly divided into study and control groups.Volunteers who complained of shoulder pain for more than a month, who had limitation in passive movement compared to the other side shoulder, who had Neer impingement test, Hawkins test, Jobe supraspinatus test, and who were able to com-municate were included in the study. Individuals 1) Having any neurological condition affecting the upper extremity, 2) having neurological findings related to cervical disc herniation, 3) having a full-thickness rupture of one of the rotator cuff tendons, 4) having calcific tendonitis, 5) having undergone previous shoulder surgery and 6) Physical therapy-rehabilitation for the shoulder with the same complaints in the last 6 months, or 7) receiving corticosteroid injection were excluded from the study. While the control group received standard physical therapy and rehabilitation, the study group underwent a progressive resistance exercise program to strengthen the humeral head depressors and peri-articular muscles, including the rotator cuff. Acromio-humeral distance (AHD) and tendon thickness measurements were evaluated by ultrasonography, while pain intensity was measured through VAS and McGill Questionnaire, upper extremity disability through DASH-T, and kinesiophobia through Fear Avoidance Beliefs Questionnaire, respectively.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Volunteers who complained of shoulder pain for more than a month,
  • Who had limitation in passive movement compared to the other side shoulder,
  • Who had Neer impingement test, Hawkins test, Jobe supraspinatus test, and -
  • Who were able to com-municate were included in the study

Exclusion criteria

  • Having any neurological condition affecting the upper extremity,
  • Having neuro-logical findings related to cervical disc herniation,
  • Having a full-thickness rupture of one of the rotator cuff tendons,
  • Having calcific tendonitis,
  • Having undergone previous shoulder surgery,
  • Physical therapy-rehabilitation for the shoulder with the same complaints in the last 6 months,
  • Receiving corticosteroid injection were excluded from the study

Treatment and study plan

Humeral Head Depressor Exercises

Behavioral

The Intervention group underwent a progressive resistance exercise program to strengthen the humeral head depressors and peri-articular muscles, including the rotator cuff. Exercises were performed 3 times per week for 6 weeks, each session lasting approximately 1 hour

Standard physical therapy

Behavioral

Participants in this group received standard physical therapy and rehabilitation as usually applied in routine care. Exercises were performed 3 times per week for 6 weeks, each session lasting approximately 1 hour. Outcomes were measured at the same time points as the intervention group.

Primary outcomes

  1. Acromio-humeral Distance (Ultrasonography, USG)

    Time frame: Baseline and 6 weeks

Secondary outcomes

  1. Tendon Thickness Measurment

    Time frame: Baseline and 6 week

    Supraspinatus Tendon, Infraspinatus Tendon, subscapularis Tendon, Teres Minor Tendon, Long Head Biceps Tendon, Rotator Cuff group Tendons General Thicknesses were evaluated in all planes, by USG using a GE LogiqP6 Pro device and a linear transducer. Imaging was performed using standard shoulder sections while the patients were in a sitting position

  2. Pain (Visual Analog Scale, VAS)

    Time frame: Baseline and 6 weeks

    Pain intensity will be assessed using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity.

  3. Pain (McGill Pain Questionnaire-Pain Rating Index)

    Time frame: Baseline and 6 weeks

    Pain will be assessed using the McGill Pain Questionnaire, specifically the Pain Rating Index (PRI). The total score ranges from 0 to 78, with higher scores indicating more severe pain.

  4. Kinesiophobia (Fear Avoidance Beliefs Questionnaire - FABQ, Physical Activity subscale)

    Time frame: Baseline and 6 weeks

    Kinesiophobia will be assessed using the Fear Avoidance Beliefs Questionnaire (FABQ) - Physical Activity subscale (items 2-5). Score range: 0 to 24 (higher scores indicate greater fear-avoidance beliefs related to physical activity).

    Time Frame: Baseline and 6 weeks.

  5. Kinesiophobia (Fear Avoidance Beliefs Questionnaire - FABQ, Work subscale)

    Time frame: Baseline and 6 weeks.

    Kinesiophobia will also be assessed using the FABQ - Work subscale (items 6, 7, 9-12, 15). Score range: 0 to 42 (higher scores indicate greater fear-avoidance beliefs related to work).

  6. Upper Extremity Disability Through (DASH-T)

    Time frame: Baseline and 6 weeks

Sponsors and collaborators

Lead sponsor

Near East University, Turkey

Other

Registry information

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Nov 14, 2025
Registry last updated
Nov 14, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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