Effect of Adding Neural Mobilization Techniques to the Conventional Physical Therapy Program in Treating Shoulder Impingement Syndrome

Document Type : Original Article


The Department Physical Therapy for Musculoskeletal Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University


Abstract Background: Shoulder impingement syndrome (SIS) is the most common disorder of the shoulder pain, accounting for 44%-65% of all complaints of shoulder pain. It is charac-terized by pain and functional restrictions, mostly during overhead activities. Aim of Study: To determine the efficacy of adding neural mobilization techniques (NMTs) to conventional physical therapy program on scapular upward rotation and ratio of upper trapezius and serratus anterior (UT/SA) isometric muscle strength in treating SIS. Patients and Methods: Thirty patients with unilateral SIS of both genders were selected, their ages ranged from 20 to 40 years (Mean ±  SD was 27.06±4.57, 26.6±5.84. Patients were randomly assigned into two groups. Group A received conventional physical therapy program and group B received NMTs for median, ulnar and radial nerves beside conventional physical therapy program. Treatment program was performed for four weeks (3 sessions/week). All patients were assessed pre and post treatment for scapular upward rotation by using baseline bubble inclinometer and UT/SA ratio by using hand held dynamometer (HHD). Results: There were no significant differences in both scapular upward rotation and UT/SA ratio between groups pretreatment (p=0.66, 0.64) and post treatment (p=0.33, 0.51), but there was a significant increase in scapular upward rotation and significant decrease in UT/SA ratio within groups (p=0.001 for both groups). Conclusions: Neural mobilization techniques in addition to conventional physical therapy program had no significant effect on scapular kinematics in patients with SIS.