Effect of manual physiotherapy in homogeneous individuals with subacromial shoulder impingement: A randomized controlled trial

Helen Land, Sue Gordon, Kerrianne Watt

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Objective: To compare the effect of specific interventions aimed at (1) the upper thoracic spine (passive mobilization) and (2) the posterior shoulder (massage, passive mobilization, and stretching) to (3) an active control intervention in a homogeneous group with extrinsic subacromial shoulder impingement (SSI).

Study Design: Single-centre, prospective, double-blinded, randomized controlled trial.

Method: Eligible individuals with clearly defined extrinsic SSI were randomized to each group. Treatment duration was 12 consecutive weeks consisting of nine treatments over 6 weeks, followed by 6 weeks when one home exercise was performed daily. Outcomes included (1) active thoracic flexion/extension range of motion, (2) passive glenohumeral internal rotation and posterior shoulder range, (3) pain rating, and (4) shoulder pain and function disability index. Data were analysed at baseline, 6 and 12 weeks. Shoulder pain and function disability index scores were investigated via email 6 months after commencement of treatment.

Results: Twenty participants completed treatment in each group. No differences were identified between groups at baseline. Upper thoracic and posterior shoulder interventions, with a targeted home exercise, both significantly decreased pain and increased function scores and increased posterior shoulder range compared with active control at 12 weeks, and 6 months following cessation of the trial.

Conclusion: Manual therapy treatment that addresses these extrinsic factors, of thoracic spine or posterior shoulder tightness, decreases the signs and symptoms of SSI. The trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR; 12615001303538).

Original languageEnglish
Article numbere1768
Number of pages14
JournalPhysiotherapy Research International
Issue number2
Publication statusPublished - Apr 2019


  • manual therapy
  • randomized controlled trial
  • subacromial shoulder impingement
  • treatment


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