NCT07290660

Graded Motor Imagery and Task-Oriented Exercise in Shoulder Impingement

Effectiveness of Graded Motor Imagery and Task-Oriented Exercise Training in Shoulder Impingement Syndrome

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 66 (estimated)
• Sponsor: Fenerbahce University · Academic / Other
• Sex: All
• Age: 25 Years – 65 Years
• Healthy volunteers: Not accepted

Summary

This study aims to compare the effects of graded motor imagery and task-oriented exercise training in individuals with shoulder impingement syndrome. A total of 66 participants aged 25-65 years will be randomly assigned to one of three groups: conventional physiotherapy, graded motor imagery, or task-oriented exercise training. All groups will receive standardized electrotherapy, while the intervention groups will additionally complete 6-week graded motor imagery or task-oriented exercise programs. Primary outcomes include pain intensity, shoulder range of motion, muscle strength, proprioception, functional status, kinesiophobia, laterality recognition, movement imagery ability, and patient satisfaction. Assessments will be conducted before and after the intervention by the same physiotherapist. The study aims to determine whether motor imagery-based or task-oriented rehabilitation provides additional benefits compared with conventional physiotherapy in individuals with shoulder impingement syndrome.

Detailed description

This study investigates the effects of graded motor imagery (GMI) and task-oriented exercise training on individuals diagnosed with shoulder impingement syndrome. Shoulder impingement is a common musculoskeletal problem that leads to pain, restricted mobility, reduced muscle strength, proprioceptive deficits, and functional limitations. Conventional physiotherapy approaches may not always be sufficient to address the complex sensorimotor deficits associated with this condition. Therefore, this study aims to evaluate whether GMI or task-oriented exercise programs can provide additional therapeutic benefits beyond standard physiotherapy. A total of 66 participants, aged 25 to 65 years, who meet the diagnostic criteria for shoulder impingement syndrome, will be included. Participants will be randomly assigned to one of three groups: Conventional physiotherapy (control group) Graded motor imagery training Task-oriented exercise training All groups will receive standardized electrotherapy interventions as part of routine physiotherapy. In addition to this standard treatment, the two intervention groups will engage in a 6-week structured program based on either GMI or task-oriented exercises, depending on group allocation. Outcome measures will include pain intensity, shoulder range of motion, muscle strength, proprioception, functional level, kinesiophobia, laterality recognition, movement imagery ability, and patient satisfaction. All assessments will be conducted before and after the 6-week intervention by the same physiotherapist to ensure consistency. The purpose of this study is to determine whether GMI or task-oriented exercise training offers superior improvements in pain, motor performance, proprioceptive control, and functional outcomes when compared with conventional physiotherapy alone. The findings are expected to contribute to evidence-based rehabilitation practices and provide clinicians with additional strategies for managing shoulder impingement syndrome.

Conditions

• Shoulder Impingement Syndrome
• Pain
• Motor Imagery Training
• Task Oriented Training

Interventions

Type	Name	Description
OTHER	Electrotherapy + Conventional Exercise Group	All participants will receive an electrotherapy program consisting of TENS (100 Hz, 20 minutes), ultrasound (1.5 W/cm², 6 minutes), and cold pack application (15 minutes), delivered 5 days per week for 6 weeks. The conventional exercise program includes wand exercises (flexion, abduction, extension, external/internal rotation), Codman exercises in multiple directions, and finger ladder exercises with a 5-second hold at end range. Strengthening exercises will be performed without resistance during the first week, followed by progressive TheraBand® resistance from week two. Posterior, anterior, and inferior capsule stretching, pectoral stretching, and shoulder-scapular mobilization will be performed under physiotherapist supervision. Exercises will be applied twice weekly for 6 weeks, with 3 sets of 10 repetitions.
OTHER	The graded motor imagery program	The graded motor imagery program consists of 2 weeks of laterality training, 2 weeks of motor imagery, and 2 weeks of mirror therapy. Laterality training will be performed using the Recognise™ Shoulder app (NOI), where participants identify whether presented images show a right or left shoulder. Training will be conducted twice weekly for 2 weeks. Motor imagery includes viewing shoulder movement images (flexion 180°, abduction 180°, external rotation 90°, internal rotation 90°, extension 45°) and mentally rehearsing the movements for 3 sets of 10 repetitions. Mirror therapy requires participants to view the reflection of their unaffected shoulder and perform the imagined movements. Mirror therapy will also be applied twice weekly for 2 weeks, with 3 sets of 10 repetitions
OTHER	The task-oriented exercise program	The task-oriented exercise program is based on daily activities related to DASH and SPADI items, focusing on functional shoulder movements including flexion, abduction, extension, and rotation. Exercises will be performed twice weekly for 6 weeks, 3 sets of 10 repetitions. Weeks 0-2 include placing an object on a front shelf, placing an object on a side shelf, placing the hand on the back, touching the neck, washing a plate, and wiping a wall within pain limits. Weeks 2-4 include changing an overhead light bulb, washing hair, combing hair, putting on and taking off a pullover shirt, and donning a jacket or cardigan. Weeks 4-6 include placing a 0.5-kg weight on an overhead shelf (front and side), washing or scratching the upper and lower back, and placing a wallet in the back pocket.

Timeline

• Start date: 2025-12-01
• Primary completion: 2026-12-30
• Completion: 2026-12-30
• First posted: 2025-12-18
• Last updated: 2025-12-18

Locations

1 site across 1 country: Turkey (Türkiye)