Percussion Massage Therapy and IASTM in Subacromial Impingement Syndrome

This assessor-blinded, three-arm, parallel-group randomized controlled trial investigated 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 were 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.

Inclusion Criteria: Men or women aged 40 to 60 years. Diagnosis of subacromial impingement syndrome confirmed by clinical examination and magnetic resonance imaging. Positive Neer test. Positive Hawkins-Kennedy test. Positive painful arc test. Shoulder symptoms persisting for at least one month. Ability and willingness to participate in the assessment and intervention programme. Provision of written informed consent. Exclusion Criteria: Previous surgery involving the affected upper extremity. Inflammatory joint disease. Shoulder osteoarthritis. Rheumatic disease. Malignant or benign tumour affecting the shoulder region or upper extremity. Open wound or active infection in the shoulder region. Inability to tolerate vibration-based therapy. Inability to comply with the study protocol or intervention programme.