Clinical Research Directory

PMT Versus IASTM in Subacromial Impingement Syndrome

This assessor-blinded, three-arm, parallel-group randomized controlled trial will investigate the additional effects of percussion massage therapy and instrument-assisted soft tissue mobilization in individuals with subacromial impingement syndrome. Forty-eight participants aged 40-60 years with clinically and magnetic resonance imaging-confirmed subacromial impingement syndrome will be randomly allocated in a 1:1:1 ratio to conventional physiotherapy, percussion massage therapy plus conventional physiotherapy, or instrument-assisted soft tissue mobilization plus conventional physiotherapy. All groups received a standardized four-week conventional physiotherapy programme. Participants in the percussion massage therapy and instrument-assisted soft tissue mobilization groups additionally received their respective interventions three times per week for four weeks. Outcomes were evaluated at baseline and immediately after the four-week intervention. The primary outcome was shoulder joint position sense during flexion and abduction. Secondary outcomes were shoulder range of motion, resting and activity-related pain, upper-extremity disability, and rotator cuff-related quality of life.

Heat Application and Shoulder Pillow for Post-Laparoscopic Shoulder Pain

The goal of this clinical trial is to learn whether heat application combined with a shoulder support pillow reduces shoulder pain in adults (18 years and older) who undergo elective laparoscopic cholecystectomy and develop shoulder pain within the first 2 hours after surgery. The main questions it aims to answer are: Does heat application with a shoulder support pillow reduce postoperative shoulder pain scores during the first 24 hours after surgery? Does it reduce incision pain and the amount of analgesics used within 24 hours after surgery? Researchers will compare patients receiving heat application and a shoulder support pillow with patients receiving routine postoperative care only, to see if the intervention lowers shoulder pain, incision pain and analgesic consumption. Participants will be randomly assigned to the intervention group or the control group. Participants in the intervention group will: Receive heat application with a towel-wrapped thermal gel pack (maximum 40°C) to the right trapezius and upper scapular region for 20 minutes at postoperative hours 2, 4, 6 and 8 Use a fiber-filled shoulder support pillow under the right shoulder and arm for 24 hours after surgery, except during mobilization Participants in the control group will: Receive no study intervention and will receive routine postoperative care only All participants in both groups will: Rate their shoulder pain and incision pain on a 0-10 Numerical Rating Scale at postoperative hours 1, 3, 5, 7, 9, 11, 20 and 24 Have their analgesic use during the first 24 hours after surgery recorded

Ultrasound-Guided Serratus Posterior Superior Intercostal Plane Block for Analgesia in Arthroscopic Shoulder Surgery

This study aimed to evaluate the effectiveness of serratus posterior superior intercostal plane (SPSIP) block in managing postoperative pain in patients undergoing arthroscopic shoulder surgery.

Yogic Eye Exercises for Computer Vision Syndrome in Female Design Students

Computer vision syndrome (CVS) is a cluster of eye and musculoskeletal complaints - dryness, redness, blurred vision, foreign body sensation, excessive tearing, and neck, shoulder or back pain - that arises from prolonged work at a digital display. It is common among university students, and optical, pharmacological and nutritional treatments have given inconsistent results. Yoga-based eye exercises have been proposed as a brief, inexpensive alternative that requires no equipment. This study tested whether a short, structured programme of yogic eye exercises reduces self-reported CVS symptoms in female undergraduates in a graphic design and digital media programme, a group whose coursework demands sustained, colour-critical near work at a screen. All 36 female students enrolled in the programme took part. Each attended one supervised training session and then performed a 13-minute sequence of relaxation exercises (slow blinking, gazing at a distant target, acupressure around the eyes) and strengthening exercises (eye rolling, nose-tip gazing) three days a week for four weeks, a total of 12 sessions, reporting completion of each session on the same day. Nine symptoms - five ocular and four musculoskeletal - were rated on a four-point scale (never, rarely, sometimes, always) at the start and again at the end of week 4. The main question was whether the average of all nine ratings fell over the four weeks. Every participant served as her own comparison; there was no control group and no masking.

Natural History of Shoulder Pathology in Manual Wheelchair Users

Over 300,000 people in the United States have spinal cord injuries and many use manual wheelchairs for mobility. Most manual wheelchair users will develop shoulder injuries and pain that greatly affect quality of life and level of independence. Understanding when shoulder disease starts in manual wheelchair users and which daily activities contribute to the disease will provide necessary evidence for effective primary prevention methods to inhibit the development of further disability. Our central hypothesis is that the development of shoulder disease in manual wheelchair users will be strongly associated with the cumulative exposure to elevated shoulder postures combined with high upper body loading.

Does MI Have a Therapeutic Role in Arthroscopic Rotator Cuff Repair?

Objective: The aim of this study is to investigate the effect of motor imagery on muscle activity, pain, and function in arthroscopic rotator cuff repair. Methods: As a result of the power analysis (G-Power), 36 participants are planned to be included in this study Block randomization will be used to divide participants into 2 groups, each with at least 18 participants: Group 1 (MI group) and Group 2 (Control group) (Randomizer.org). Both groups will receive a 4-week physical therapy program. MI (Motor Imagination) group will receive a motor imagination program in addition to the physical therapy program. Data will collect using the visual analog scale (VAS), goniometric measurement, circumference measurement, Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), Kinesthetic and Visual Imagery Questionnaire- KVIQ-20, Tampa Kinesiophobia Scale, 3-question satisfaction questionnaire, superficial Electromyography (EMG) (BTS Bioengineering Free EMG 100 RT). Practice Implications: The current study will contribute to understanding how motor imagination affects muscle activity and muscle atrophy.

Night Pain Module for Rotator Cuff-Related Shoulder Pain

Night pain is common in people with rotator cuff-related shoulder pain and may disturb sleep and daily life. It may include difficulty falling asleep, waking because of pain, increased pain during the night, difficulty returning to sleep, and pain when lying on the affected shoulder. However, night pain is often assessed with only one pain score or a yes/no question. This study aims to develop and evaluate a short Night Pain Module for people with rotator cuff-related shoulder pain. The current draft contains eight items assessing different features of night pain during the previous seven days. The items may be revised after expert review and pilot testing. The validity and reliability of the final version will be examined in the main study. A subgroup of participants will complete the module again after 7-10 days. No treatment or experimental procedure will be given as part of the study.

Nociplastic Pain in Patients Diagnosed With Subacromial Pain Syndrome (SAPS)

The goal of this cross-sectional study is to estimate the prevalence of the nociplastic pain phenotype, according to the IASP clinical criteria, among patients diagnosed with SubAcromial Pain Syndrome (SAPS). The main question it aims to answer is: What is the prevalence of the nociplastic pain phenotype in patients diagnosed with SAPS in an outpatient clinic? Primary outcome: Proportion of patients with SAPS meeting the IASP criteria for nociplastic pain.

Pain Phenotype and Response to Corticosteroid Injection in Patients With Subacromial Pain Syndrome (SAPS)

The goal of this prospective cohort study is to investigate whether pain phenotype is associated with subsequent change in pain intensity after corticosteroid injection given as part of routine care in patients diagnosed with SAPS. The main question it aims to answer is: Does change in shoulder pain from baseline to 4 weeks after corticosteroid injection differ between patients classified as having a nociplastic pain phenotype and those classified as having a non-nociplastic pain phenotype?

Functional Electrical Stimulation Combined With Exercise for Rotator Cuff-Related Shoulder Pain in Older Adults

The goal of this clinical trial is to learn whether adding functional electrical stimulation (FES) to a shoulder exercise program improves how the shoulder muscles work together in older adults with rotator cuff-related shoulder pain. FES uses small electrical currents delivered through pads on the skin to help muscles contract. The main questions it aims to answer are: 1. Does exercise combined with FES improve coordination between the rotator cuff and deltoid muscles more than exercise alone? 2. Does exercise combined with FES increase the space between the top of the upper arm bone and the shoulder blade (acromiohumeral distance), which may reduce pinching of the shoulder tendons? Researchers will compare a group that receives resistance exercise with FES to a group that receives the same resistance exercise without FES. Participants will: 1. Attend exercise sessions 3 times per week for 4 weeks (12 sessions) 2. Complete 4 testing visits: before training, after 2 weeks, after 4 weeks, and 4 weeks after training ends 3. At each testing visit, perform shoulder strength tasks while muscle activity is recorded with sensors on the skin and thin wire sensors placed in the muscle, have an ultrasound of the shoulder, and complete questionnaires about shoulder pain and function

Effects of Respiratory Muscle Strengthening and Diaphragmatic Breathing on Shoulder Pain and Disability

The aim of the study is to investigate the effects of respiratory muscle strengthening and diaphragmatic breathing on pain levels, respiratory capacity and sleep quality in participants with shoulder pain and disability.

Mobile App-Assisted Home Exercise for Musculoskeletal Disorders

Overview This study evaluates the effectiveness of a dedicated mobile health (mHealth) application in supporting home exercise programs for patients with musculoskeletal disorders, such as neck, shoulder, back, or knee pain. The research aims to address the widespread challenge of low patient adherence to unsupervised home-based exercises. Study Design The project employs a dual-methodology approach: Clinical Trial: 30 participants presenting with neck, shoulder, back, or knee pain will be randomly assigned to either an app-assisted group or a traditional home exercise group. Both groups will undergo 4 weeks of physiotherapy. The study will compare pain intensity, physical function, and exercise adherence between the two cohorts. Retrospective Analysis: To complement the trial, the study will analyze a large-scale database containing approximately 700,000 anonymized real-world data entries. This analysis aims to observe real-time pain fluctuations before and after exercise sessions within routine clinical settings. Goal The primary objective is to determine if integrating mHealth technology into traditional rehabilitation can enhance clinical outcomes and improve patient adherence to home-based exercise routines.

Evaluating Hemidiaphragmatic Paralysis With Prolonged Neural Blockade From an Interscalene Brachial Plexus Block

This prospective observational study aims to evaluate the incidence of hemidiaphragmatic paralysis in patients receiving interscalene brachial plexus nerve block with prolonged neural blockade. English speaking American Society of Anesthesiologists (ASA) 1-3 patients ages 18-80 receiving prolonged interscalene nerve block will be randomized into 3 groups: first group receiving a perineural catheter infusing 0.2% ropivacaine; the second group receiving a single shot injection of 10mL liposomal bupivacaine (Exparel; n=20) plus 5 mL 0.5% bupivacaine and the third receiving 20mL liposomal bupivacaine plus 5mL bupivacaine (to be determined by the attending anesthesiologist).Primary outcome will be incidence of hemidiaphragmatic paralysis postoperative day 1 as measured by point of care (POCUS) ultrasound.

Neck and Shoulder Pain in Homemakers

This cross-sectional observational study aims to investigate the prevalence and associated factors of neck and shoulder pain in homemakers aged 25-55 years. The study will examine the relationships between neck and shoulder pain and demographic characteristics, duration and type of housework, fatigue, physical activity, smartphone and social media use, hobbies, posture, functional status, instrumental activities of daily living, and health-related quality of life. Neck-related disability will be assessed using the Neck Disability Index, upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, instrumental activities of daily living using the Lawton and Brody Instrumental Activities of Daily Living Scale, quality of life using the SF-12 Health Survey, and posture using the New York Posture Rating Chart. The findings are expected to contribute to identifying factors associated with neck and shoulder pain in homemakers and to inform future preventive and rehabilitative approaches.

The Efficacy and Safety of Shoulder Motion Style Acupuncture Treatment (MSAT) on in Patients With Shoulder Pain Caused by Traffic Accidents

This study will test the effectiveness and safety of Motion Style Acupuncture Treatment (MSAT) for shoulder pain caused by traffic accidents. About 98 hospitalized patients with acute shoulder pain after a traffic accident will take part. Participants will be randomly assigned to one of two groups: MSAT + integrative Korean medicine group (acupuncture, herbal medicine, pharmacopuncture, Chuna therapy, plus MSAT), or Integrative Korean medicine only group (acupuncture, herbal medicine, pharmacopuncture, Chuna therapy). MSAT involves inserting needles into the shoulder area and gently moving the joint to improve pain relief and mobility. All treatments used in this study are standard care in Korean medicine. The main outcomes are pain reduction, shoulder movement, daily function, quality of life, and patient satisfaction. Safety will also be monitored by recording any side effects such as temporary soreness, bruising, or discomfort. Treatment will be provided during hospitalization (up to 5 days), and patients will be followed up by phone at 2 weeks and 1 month after enrollment. The results of this trial will help determine whether adding MSAT to standard integrative Korean medicine treatment provides greater benefit for patients with acute shoulder pain after traffic accidents.

Personalised Education Versus Usual Physiotherapy for Acute Rotator Cuff-Related Shoulder Pain

Rotator cuff-related shoulder pain (RCRSP) is one of the most common musculoskeletal disorders presenting in primary care. It is frequently associated with persistent pain, disability, healthcare utilisation and work absenteeism. Exercise-based physiotherapy is recommended as first-line management in clinical practice guidelines, yet its average effects on pain and disability are modest and a substantial proportion of people remain symptomatic several months after onset. Patient education is also recommended, and trials conducted in people with persistent symptoms suggest that education-based care may produce improvements comparable to those obtained with progressive exercise. However, the effectiveness of a structured educational intervention as a first-line management strategy during the acute phase of RCRSP remains unclear. SHOULD Education lead Rehabilitation? (SHOULD-ER) is a multicentre, pragmatic, parallel-group, non-inferiority randomised controlled trial comparing a personalised, multimodal educational intervention with usual physiotherapy care in adults presenting with acute non-traumatic RCRSP of less than six weeks duration. Participants will be randomly assigned to one of the trial arms for a 12-week treatment period, with follow-up to 24 weeks. The primary objective is to determine whether the educational intervention is non-inferior to usual physiotherapy care regarding improvement in shoulder pain and disability at 12 weeks, measured by the Shoulder Pain and Disability Index (SPADI). Secondary outcomes include pain-related function, self-efficacy, fear-avoidance beliefs, quality of life, sleep quality, patient satisfaction and healthcare costs. A nested qualitative study and a within-trial economic evaluation are embedded in the trial. An exploratory analysis of prognostic factors will also be conducted with a secondary analysis.

Patient Education and Sling Use After Shoulder Surgery

This study will evaluate whether educational pamphlets can help patients safely manage personal hygiene, household activities, and female-specific self-care while wearing a sling after surgery. The study will also examine whether following sling-use instructions is associated with better short-term recovery and patient-reported outcomes for up to 6 months after surgery.

Bupivacaine With Epinephrine Over Diaphragm in Laparoscopy

Postoperative shoulder pain is often reported to be particularly bothersome after laparoscopy. The benefits of local anesthetic, such as bupivacaine, applied to subcutaneous tissue for general postoperative pain management after surgery is well established. However, there have been no studies on sprayed bupivacaine over the diaphragm to reduce shoulder pain in laparoscopic surgery. The purpose of the study is to evaluate if sprayed infra-diaphragmatic bupivacaine compared to placebo (saline) will improve postoperative shoulder pain in patients undergoing benign laparoscopic gynecologic surgery. The entire study will be conducted at Cedar Sinai Medical Center.

Effect of Kinesio Taping After Rotator Cuff Surgery

This prospective randomized controlled trial evaluated whether adding Kinesio Taping (KT) to a standardized postoperative rehabilitation program improves early clinical recovery after arthroscopic rotator cuff repair. Patients undergoing arthroscopic repair of an isolated full-thickness supraspinatus tear were randomized to receive either standardized rehabilitation combined with KT or standardized rehabilitation alone. Postoperative pain intensity was the primary outcome. Secondary outcomes included shoulder range of motion, postoperative edema, Constant-Murley Score, QuickDASH score, and postoperative complications. Participants were assessed preoperatively and on postoperative day 1, week 2, week 6, and month 3.

OsseoFit Stemless Shoulder System (Anatomic)

The purpose of this clinical research protocol is to evaluate the safety, efficacy, and long-term outcomes of the OsseoFit Stemless Shoulder System (Anatomic) in patients with a primary diagnosis of osteoarthritis. The study aims to assess the intraoperative characteristics, postoperative complications, functional outcomes, and radiographic findings associated with the use of the stemless implant system. Ultimately, this research aims to improve patient outcomes, enhance surgical techniques, and inform clinical decision-making in the treatment of shoulder pathology.

Ultrasound and Shear Wave Elastography for Assessment of the Quality of Rotator Cuff Muscles

Rotator cuff disorders are among the most frequent musculoskeletal causes of shoulder pain, weakness, and limited movement. In many individuals with rotator cuff disease, the damaged muscles gradually shrink (muscle atrophy) and become replaced by fat tissue (fatty infiltration), particularly involving the supraspinatus and infraspinatus muscles. These structural changes can impair shoulder function, reduce the likelihood of successful tendon repair surgery, and increase the risk of recurrent tears. Magnetic resonance imaging (MRI) is the established standard for assessing rotator cuff muscle health, but it is expensive, time-consuming, and not suitable for all individuals. Musculoskeletal ultrasound offers an accessible, real-time alternative, and shear wave elastography (SWE) adds the capability to quantitatively measure tissue stiffness. The purpose of this study is to evaluate the diagnostic accuracy and validity of combining conventional ultrasound with shear wave elastography to assess rotator cuff muscle quality, specifically fatty infiltration and muscle atrophy, in comparison with reference MRI or CT scans. Participants aged 18 years or older with suspected rotator cuff disorders who have had a qualifying shoulder MRI or CT scan within the previous 12 months will undergo an ultrasound and shear wave elastography examination of the affected shoulder. Researchers will calculate shear wave velocity and muscle occupation ratios to assess muscle stiffness and volume, and compare these results to validated MRI grading scales (the Goutallier classification for fat infiltration and the Warner staging system for muscle atrophy).

VR-Assisted Rehabilitation in Partial Supraspinatus Tears

This randomized controlled trial investigated the effects of virtual reality-assisted rehabilitation in patients with partial supraspinatus tendon tears. Partial supraspinatus tears are a common cause of shoulder pain, functional limitation, restricted range of motion, and fear of movement. Conservative rehabilitation is commonly used as first-line treatment, while evidence regarding immersive virtual reality rehabilitation in this patient population remains limited. Participants were randomly allocated to either a virtual reality-assisted rehabilitation group or a conventional rehabilitation group. Both groups received the same physical therapy modalities, including hot pack, therapeutic ultrasound, and transcutaneous electrical nerve stimulation. The control group subsequently performed conventional therapeutic shoulder exercises, whereas the virtual reality group performed approximately equal-duration immersive VR-based exercises instead of the conventional exercise component. Outcomes included pain, shoulder range of motion, disability, kinesiophobia, health-related quality of life, and supraspinatus tendon thickness.

Dry Needling or Percutaneous Electrolysis for Managing Myofascial Trigger Points?

Dry needling (DN) and percutaneous electrolysis (PE) are minimally invasive physiotherapy techniques commonly used for the management of myofascial trigger points. DN consists of inserting a fine filiform needle into a hyperirritable area within a taut band of skeletal muscle, with the aim of eliciting local twitch responses and reducing myofascial pain. PE follows a similar needle-based approach but combines the mechanical stimulus of the needle with the application of a galvanic electrical current, producing an electrochemical reaction in the targeted tissue. Both techniques have been increasingly used in clinical practice for musculoskeletal pain conditions, including shoulder pain, although the evidence comparing their relative effectiveness remains limited. Shoulder pain is one of the most prevalent musculoskeletal disorders and is frequently associated with the presence of active myofascial trigger points. Among the shoulder muscles, the infraspinatus has been identified as a clinically relevant structure because its trigger points may reproduce referred pain patterns commonly reported by patients with shoulder symptoms and may contribute to pain, reduced strength, altered mobility, and functional disability. Previous studies have suggested that invasive treatment of infraspinatus trigger points may produce short-term improvements in pain sensitivity and shoulder-related symptoms. However, most available research has examined dry needling or percutaneous electrolysis separately, and direct comparisons between both interventions in patients with shoulder pain remain scarce. The physiological mechanisms underlying these techniques are not yet fully understood. Dry needling is thought to act through mechanical and neurophysiological mechanisms, including disruption of dysfunctional motor endplates, reduction of local nociceptive input, elicitation of local twitch responses, and activation of segmental and descending inhibitory pathways. Percutaneous electrolysis may share some of these needling-related effects, while also adding a galvanic current that may induce local biochemical changes and promote tissue recovery processes. Nevertheless, it remains unclear whether the addition of electrical current provides superior clinical effects compared with dry needling alone. Since limited research has directly compared dry needling and percutaneous electrolysis applied to active myofascial trigger points of the infraspinatus in patients with shoulder pain, the present study aimed to compare the effectiveness of both techniques as complementary interventions to manual therapy and therapeutic exercise. Specifically, this study sought to determine whether percutaneous electrolysis or dry needling produced greater short-term improvements in pain intensity and shoulder-related disability.

Anatomically-Guided Electroacupuncture Combined With Cupping for Shoulder Pain

This study compares two acupuncture-based treatments for shoulder pain. Adults with shoulder pain will be randomly assigned to one of two groups. One group will receive electroacupuncture at points chosen based on the anatomy of the painful muscle, combined with moving cupping therapy. The other group will receive electroacupuncture using a standard set of traditional acupuncture points. Both groups will receive daily treatment for 5 days. The main question is whether the combined treatment reduces pain and improves shoulder function more than standard electroacupuncture, measured using a shoulder pain and disability questionnaire completed before treatment and after each session.