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.

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.