Subacromial Pain SyndromeNCT07043842
Effect of Thoracic Mobility Exercises Combined With Scapular Stabilization Exercises in Individuals With Subacromial Pain Syndrome
A study testing Shoulder circumference exercises, Scapular stabilization exercises and Thoracic mobility exercises in people with Subacromial Pain Syndrome, run by Ankara Yildirim Beyazıt University at 1 site in Turkey (Türkiye).
Trial summary
The subject of this study is to examine the effects of thoracic mobility exercises combined with scapular stabilization exercises on pain, range of motion, scapular alignment, postural alignment and quality of life in individuals with subacromial pain syndrome. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Subacromial Pain Syndrome
- What is being tested?
- Shoulder circumference exercises, Scapular stabilization exercises and Thoracic mobility exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 28 Jul 2025to 28 Sep 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Volunteering to participate in the study
- Being between the ages of 18-60
- Being diagnosed with subacromial pain syndrome
- Having Stage I or Stage II subacromial pain syndrome according to Neer
- Having unilateral shoulder pain that limits activity for more than 6 weeks
- Having pain intensity over 3 according to VAS
Who cannot join
- Having cervical radiculopathy
- Having spinal deformities
- Having post-traumatic symptom onset
- Having a history of shoulder dislocation or fracture
- Having passive joint movement limitation (frozen shoulder)
- Having received steroid injections within the last 6 weeks
- Having degenerative joint disease of the shoulder joint complex, having a history of surgical intervention to the shoulder joint complex, having any diagnosed rheumatic, systemic or neurological disease
- Having cardiovascular pathologies that limit rehabilitation
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Effects of Thoracic Mobility Exercises Combined With Scapular Stabilization Exercises on Pain, Range of Motion, Scapular Alignment, Postural Alignment and Quality of Life in Individuals With Subacromial Pain Syndrome
The subject of this study is to examine the effects of thoracic mobility exercises combined with scapular stabilization exercises on pain, range of motion, scapular alignment, postural alignment and quality of life in individuals with subacromial pain syndrome.
The scapula assumes a role that is attached to the axial skeleton by atmospheric pressure and axioscapular muscles, and prepares the ground for the formation of wide range of motion in the shoulder complex. The scapulothoracic movement formed by the movement of the scapula on the thorax is provided not only by the function of the scapular muscles but also by the optimization of the thoracic muscles and posture.
Therefore, changes in the biomechanics of the thoracic spine and scapula affect the function of the shoulder. Therefore, we predict that the possible contributions of scapular stabilization and thoracic mobility exercises to scapular alignment and alignment in thoracic posture will further improve shoulder-related complaints.
Read the detailed description
Subacromial pain syndrome is one of the most common causes of shoulder pain. Factors leading to rotator cuff pathology due to decreased subacromial space play a role in its development. Depending on the stage of Subacromial Pain Syndrome; edema and hemorrhage in subacromial tissues, pain and tenderness in the lateral shoulder, fibrosis in the glenohumeral capsule and subacromial bursa, tendonitis in the affected tendons, abrasion, ruptures or osteophytes may develop in tendons. Again depending on the stage; postural changes such as increased downward rotation and anterior tilt in the scapula, loss of active-passive range of motion, atrophy in the rotator cuff and deltoid muscles may be observed. These disorders cause imbalances that may prevent optimal scapulohumeral rhythm. Changes in the biomechanics of the thoracic spine and scapula affect the function of the shoulder. Extension of the thoracic spine is significantly limited in subacromial pain syndrome. The scapula can also assume a significantly increased anterior tilt, internal rotation, protraction and decreased upward rotation position. This situation indicates that interventions are needed to improve limited thoracic extension and altered scapular position that may affect shoulder joint motion and muscle strength in the rehabilitation of individuals with subacromial pain syndrome.
A study on young tennis players, including thoracic region mobility exercises, based on the idea that increased thoracic kyphosis reduces shoulder functional capacity, has yielded effective results in correcting sagittal thoracic curvature and increasing thoracic mobility. It also strongly increased glenohumeral internal and external rotation range of motion.
Throwing injuries to the shoulder joint often occur during shoulder external rotation. Therefore, an appropriate combination of thoracic, scapular and humeral motion during throwing is important to prevent such injuries. Thoracic extension increases scapular posterior tilt and external rotation during shoulder external rotation and decreases glenohumeral horizontal abduction, and also increases maximum shoulder external rotation. It has been shown that providing thoracic extension can contribute to reducing mechanical demands on the glenohumeral joint during activities such as throwing and can potentially reduce shoulder injuries. Restricting thoracic extension can reduce scapulothoracic movement and cause excessive glenohumeral joint movement, which can be a risk factor for shoulder injuries. The finding of a significant positive correlation between scapular posterior tilt and glenohumeral external rotation also provides an idea about the posture that should be adopted to reduce the risk of injury. Therefore, during shoulder movements, it is necessary to correct the posture of the thoracic spine in order to prevent the incompatibility of scapula and thorax movements due to posture. Based on this, it is expected that the study to be conducted will shed light on the rehabilitation of individuals with subacromial pain syndrome by demonstrating the effectiveness of thoracic mobility exercises.
- Conditions
- Subacromial Pain Syndrome
- Being tested
- Shoulder circumference exercises, Scapular stabilization exercises, Thoracic mobility exercises
- Keywords
- subacromial pain syndrome, scapular stabilization exercises, thoracic mobility exercises
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Shoulder circumference exercisesOther
They are strengthening and stretching exercises that support the range of motion of the shoulder joint.
Scapular stabilization exercisesOther
Changes in the biomechanics of the scapula affect the function of the shoulder. Biomechanical correction will be attempted with these exercises aimed at correcting the posture of the scapula.
Thoracic mobility exercisesOther
Changes in the biomechanics of the thoracic spine affect the function of the shoulder. Biomechanical correction will be attempted with these exercises aimed at correcting the posture of the thoracic spine.
| Study group | Role | What they receive |
|---|---|---|
| Treatment group | Experimental | This group consists of patients who will undergo shoulder circumference exercises and scapular stabilization exercises along with thoracic mobility exercises. Receives: Other: Shoulder circumference exercises; Other: Scapular stabilization exercises; Other: Thoracic mobility exercises |
| Control group | Active comparator | This group consists of patients who will undergo shoulder circumference exercises and scapular stabilization exercises. Receives: Other: Shoulder circumference exercises; Other: Scapular stabilization exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Assessment of pain intensity
Pain intensity will be assessed with the Visual Analog Scale (VAS). Patients are asked to mark the intensity of pain they feel at rest, during elevation, and at night on the scale. The patient is asked to position the pain intensity between "No Pain at All" and "Very Severe Pain" at one end. The area from the point "0" where there is no pain to the point they mark is measured.
Measured: Change from the initial level after the 6-week treatment program.
Evaluation of joint range of motion
Joint range of motion will be assessed with the smartphone goniometer application. Measurements will be made in the form of painless and painful active joint range of motion and passive joint range of motion assessments of the shoulder in all directions.
Measured: Change from the initial level after the 6-week treatment program.
Pectoralis minor shortness assessment
While standing in a free standing position, the distance between the coracoid process of the scapula and the 4th rib will be measured with a tape measure. The determined length will be divided by the patient's height in cm and multiplied by 100 to obtain the pectoralis minor index (PMI).
Measured: Change from the initial level after the 6-week treatment program.
Scapular alignment assessment
Lateral Scapular Slip Test (LSKT) will be used to assess scapular alignment. It is applied according to the procedure described by Kibler. Accordingly; 3 test positions are used. In the first position; The shoulder glenohumeral joint is in a neutral position, the humerus is in a medial rotation position with 45° abduction in the coronal plane in the second test position, and the shoulder is in a medial rotation position with 90° abduction in the coronal plane in the third test position. In the test where the distance of the scapula from the midline is measured; the horizontal distance from the T4 spinous process to the medial corner of the scapula is measured with a tape measure. A distance difference of 1.5 cm or more between the two sides is defined as positive LSKT by Kibler.
Measured: Change from the initial level after a 6-week treatment program.
Evaluation of thoracic kyphosis
Thoracic kyphosis will be assessed with a smartphone inclinometer application. The short side of the smartphone is placed over the anatomical reference points (T1-T3, T12) marked on the spine. First, the phone is placed on the T1-T3 spinous process and the protractor is set to 0°, then the phone is placed on the T12 spinous process and the angular value displayed on the screen is recorded as the degree of kyphosis.
Measured: Change from the baseline after a 6-week treatment program.
Evaluation of shoulder-related quality of life
Western Ontario Rotator Cuff Index (WORC): The WORC, whose Turkish adaptation has been shown to be reliable and valid, will be used to determine the effectiveness of rehabilitation on quality of life. It consists of 5 sections including physical symptoms, sports and leisure, work, lifestyle and emotional functions and a total of 21 questions. In the WORC index, evaluation results can be given as raw scores and one hundred points. The best possible score is 0 (% 100) and there is no decrease in the patient's shoulder-related quality of life; the worst possible score is 2100 (% 0) and the patient has a very significant decrease in the shoulder-related quality of life.
Measured: Change from baseline after 6-week treatment program.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Jun 2025
- Study start28 Jul 2025 (estimated)
- Primary completion28 Sep 2026 (estimated)
- Study completion28 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Subacromial Pain SyndromeStudies of the same condition, open and under way.
- More trials run by Ankara Yildirim Beyazıt UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 20 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Ankara Yildirim Beyazıt University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Zeynel Abidin Çapa, MSc, Principal investigator, Hitit University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07043842
- Sponsor's protocol ID
- 16.01.2025-01/1119
- Status last verified
- Jun 2025
- First submitted
- 21 Jun 2025
- Last updated
- 29 Jun 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Indivudual participant data will be available to the responsible researcher.
Study at a glance
From the registry record, last updated by the sponsor on 29 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Thoracic Mobility Exercises Combined With Scapular Stabilization Exercises on Pain, Range of Motion, Scapular Alignment, Postural Alignment and Quality of Life in Individuals With Subacromial Pain Syndrome
- ClinicalTrials.gov ID
- NCT07043842
- Acronym / sponsor ID
- 16.01.2025-01/1119
- Conditions
- Subacromial Pain Syndrome
- Keywords
- subacromial pain syndrome, scapular stabilization exercises, thoracic mobility exercises
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 20 participants (estimated)
- Lead sponsor
- Ankara Yildirim Beyazıt UniversityUniversity, hospital or other
- Study start
- 28 Jul 2025 (estimated)
- Primary completion
- 28 Sep 2026 (estimated)
- Study completion
- 28 Sep 2026 (estimated)
- First posted
- 29 Jun 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The subject of this study is to examine the effects of thoracic mobility exercises combined with scapular stabilization exercises on pain, range of motion, scapular alignment, postural alignment and quality of life in individuals with subacromial pain syndrome.
The scapula assumes a role that is attached to the axial skeleton by atmospheric pressure and axioscapular muscles, and prepares the ground for the formation of wide range of motion in the shoulder complex. The scapulothoracic movement formed by the movement of the scapula on the thorax is provided not only by the function of the scapular muscles but also by the optimization of the thoracic muscles and posture.
Therefore, changes in the biomechanics of the thoracic spine and scapula affect the function of the shoulder. Therefore, we predict that the possible contributions of scapular stabilization and thoracic mobility exercises to scapular alignment and alignment in thoracic posture will further improve shoulder-related complaints.
Detailed description
Subacromial pain syndrome is one of the most common causes of shoulder pain. Factors leading to rotator cuff pathology due to decreased subacromial space play a role in its development. Depending on the stage of Subacromial Pain Syndrome; edema and hemorrhage in subacromial tissues, pain and tenderness in the lateral shoulder, fibrosis in the glenohumeral capsule and subacromial bursa, tendonitis in the affected tendons, abrasion, ruptures or osteophytes may develop in tendons. Again depending on the stage; postural changes such as increased downward rotation and anterior tilt in the scapula, loss of active-passive range of motion, atrophy in the rotator cuff and deltoid muscles may be observed. These disorders cause imbalances that may prevent optimal scapulohumeral rhythm. Changes in the biomechanics of the thoracic spine and scapula affect the function of the shoulder. Extension of the thoracic spine is significantly limited in subacromial pain syndrome. The scapula can also assume a significantly increased anterior tilt, internal rotation, protraction and decreased upward rotation position. This situation indicates that interventions are needed to improve limited thoracic extension and altered scapular position that may affect shoulder joint motion and muscle strength in the rehabilitation of individuals with subacromial pain syndrome.
A study on young tennis players, including thoracic region mobility exercises, based on the idea that increased thoracic kyphosis reduces shoulder functional capacity, has yielded effective results in correcting sagittal thoracic curvature and increasing thoracic mobility. It also strongly increased glenohumeral internal and external rotation range of motion.
Throwing injuries to the shoulder joint often occur during shoulder external rotation. Therefore, an appropriate combination of thoracic, scapular and humeral motion during throwing is important to prevent such injuries. Thoracic extension increases scapular posterior tilt and external rotation during shoulder external rotation and decreases glenohumeral horizontal abduction, and also increases maximum shoulder external rotation. It has been shown that providing thoracic extension can contribute to reducing mechanical demands on the glenohumeral joint during activities such as throwing and can potentially reduce shoulder injuries. Restricting thoracic extension can reduce scapulothoracic movement and cause excessive glenohumeral joint movement, which can be a risk factor for shoulder injuries. The finding of a significant positive correlation between scapular posterior tilt and glenohumeral external rotation also provides an idea about the posture that should be adopted to reduce the risk of injury. Therefore, during shoulder movements, it is necessary to correct the posture of the thoracic spine in order to prevent the incompatibility of scapula and thorax movements due to posture. Based on this, it is expected that the study to be conducted will shed light on the rehabilitation of individuals with subacromial pain syndrome by demonstrating the effectiveness of thoracic mobility exercises.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Treatment group | Experimental | Other: Shoulder circumference exercises, Other: Scapular stabilization exercises, Other: Thoracic mobility exercisesThis group consists of patients who will undergo shoulder circumference exercises and scapular stabilization exercises along with thoracic mobility exercises. |
| Control group | Active comparator | Other: Shoulder circumference exercises, Other: Scapular stabilization exercisesThis group consists of patients who will undergo shoulder circumference exercises and scapular stabilization exercises. |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- Volunteering to participate in the study
- Being between the ages of 18-60
- Being diagnosed with subacromial pain syndrome
- Having Stage I or Stage II subacromial pain syndrome according to Neer
- Having unilateral shoulder pain that limits activity for more than 6 weeks
Key exclusion criteria (8 listed)
- Having cervical radiculopathy
- Having spinal deformities
- Having post-traumatic symptom onset
- Having a history of shoulder dislocation or fracture
- Having passive joint movement limitation (frozen shoulder)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Shoulder circumference exercisesThey are strengthening and stretching exercises that support the range of motion of the shoulder joint. | Other | Control group, Treatment group |
| Scapular stabilization exercisesChanges in the biomechanics of the scapula affect the function of the shoulder. Biomechanical correction will be attempted with these exercises aimed at correcting the posture of the scapula. | Other | Control group, Treatment group |
| Thoracic mobility exercisesChanges in the biomechanics of the thoracic spine affect the function of the shoulder. Biomechanical correction will be attempted with these exercises aimed at correcting the posture of the thoracic spine. | Other | Treatment group |
Primary outcome
Assessment of pain intensity
Time frame: Change from the initial level after the 6-week treatment program.
Pain intensity will be assessed with the Visual Analog Scale (VAS). Patients are asked to mark the intensity of pain they feel at rest, during elevation, and at night on the scale. The patient is asked to position the pain intensity between "No Pain at All" and "Very Severe Pain" at one end. The area from the point "0" where there is no pain to the point they mark is measured.
Evaluation of joint range of motion
Time frame: Change from the initial level after the 6-week treatment program.
Joint range of motion will be assessed with the smartphone goniometer application. Measurements will be made in the form of painless and painful active joint range of motion and passive joint range of motion assessments of the shoulder in all directions.
Pectoralis minor shortness assessment
Time frame: Change from the initial level after the 6-week treatment program.
While standing in a free standing position, the distance between the coracoid process of the scapula and the 4th rib will be measured with a tape measure. The determined length will be divided by the patient's height in cm and multiplied by 100 to obtain the pectoralis minor index (PMI).
Scapular alignment assessment
Time frame: Change from the initial level after a 6-week treatment program.
Lateral Scapular Slip Test (LSKT) will be used to assess scapular alignment. It is applied according to the procedure described by Kibler. Accordingly; 3 test positions are used. In the first position; The shoulder glenohumeral joint is in a neutral position, the humerus is in a medial rotation position with 45° abduction in the coronal plane in the second test position, and the shoulder is in a medial rotation position with 90° abduction in the coronal plane in the third test position. In the test where the distance of the scapula from the midline is measured; the horizontal distance from the T4 spinous process to the medial corner of the scapula is measured with a tape measure. A distance difference of 1.5 cm or more between the two sides is defined as positive LSKT by Kibler.
Evaluation of thoracic kyphosis
Time frame: Change from the baseline after a 6-week treatment program.
Thoracic kyphosis will be assessed with a smartphone inclinometer application. The short side of the smartphone is placed over the anatomical reference points (T1-T3, T12) marked on the spine. First, the phone is placed on the T1-T3 spinous process and the protractor is set to 0°, then the phone is placed on the T12 spinous process and the angular value displayed on the screen is recorded as the degree of kyphosis.
Evaluation of shoulder-related quality of life
Time frame: Change from baseline after 6-week treatment program.
Western Ontario Rotator Cuff Index (WORC): The WORC, whose Turkish adaptation has been shown to be reliable and valid, will be used to determine the effectiveness of rehabilitation on quality of life. It consists of 5 sections including physical symptoms, sports and leisure, work, lifestyle and emotional functions and a total of 21 questions. In the WORC index, evaluation results can be given as raw scores and one hundred points. The best possible score is 0 (% 100) and there is no decrease in the patient's shoulder-related quality of life; the worst possible score is 2100 (% 0) and the patient has a very significant decrease in the shoulder-related quality of life.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jun 2025.
- Individual participant dataSharing planned: No. Indivudual participant data will be available to the responsible researcher.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Zeynel Abidin Çapa, MSc principal investigator
Hitit University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Shoulder circumference exercises, Scapular stabilization exercises and Thoracic mobility exercises in people with Subacromial Pain Syndrome, run by Ankara Yildirim Beyazıt University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 29 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Zeynel Abidin Çapa, Msc (+905543789285, fztzacapa@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Assessment of pain intensity (time frame: Change from the initial level after the 6-week treatment program.). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jun 2025.