NCT07525297

Mulligan's Mobilization in Rotator Cuff Pathology

The Effect of Adding Thoracic Mobilization to Mulligan's Mobilization With Movement in Individuals With Rotator Cuff Pathology

• Status: Not Yet Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 40 (estimated)
• Sponsor: Yuzuncu Yil University · Academic / Other
• Sex: All
• Age: 18 Years – 65 Years
• Healthy volunteers: Not accepted

Summary

Rotator cuff pathology is defined as the degeneration or tear of one or more of the muscles or tendons of the rotator cuff, namely the supraspinatus, infraspinatus, teres minor, and subscapularis. Shoulder girdle biomechanics are not solely comprised of the glenohumeral joint but are built upon a kinetic chain involving the synchronized movement of the scapula, clavicle, and thoracic spine. In this context, the concept described in the literature as the "Regional Dependence" model argues that functional impairment in a distal segment like the shoulder may stem from or exacerbate limitations in a more proximal region like the thoracic spine. Conventional treatment approaches that focus solely on the shoulder joint may have limited clinical outcomes due to neglecting the fundamental link in the kinetic chain. Maintained natural apophyseal glides (SNAGs), a cornerstone of Mulligan's Concept in spinal rehabilitation, are a dynamic manual therapy technique aimed at correcting microscopic misalignments in facet joints during active movement. The aim of this randomized controlled trial is to investigate the effects of thoracic mobilization added to the Mulligan movement shoulder mobilization technique on pain intensity, range of motion, proprioception, and upper extremity functionality in individuals with rotator cuff pathology, and to evaluate the superiority of this combined approach over shoulder mobilization alone. Assessments will be performed before treatment and at the end of the 3-week intervention. Rest and activity pain intensity will be assessed using the Pain Numerical Rating Scale (PMR), shoulder range of motion using a digital goniometer, thoracic kyphosis degrees using a smartphone with the 'Angle Meter' software installed and calibrated gyroscope and accelerometer sensors, functionality using the Shoulder Pain and Disability Index (SPAI), and proprioception using a laser pointer and target device. The obtained data will be compared using appropriate statistical analysis methods. This study is expected to provide scientific evidence regarding the clinical effectiveness of thoracic mobilization technique added to shoulder mobilization technique applied in conjunction with conventional treatment in individuals with rotator cuff pathology, and to contribute to filling the methodological gap mentioned in the literature.

Conditions

• Rotator Cuff Injuries

Interventions

Type	Name	Description
PROCEDURE	Mulligan Mobilization with Movement	Mobilization with Movement technique applied to the shoulder joint according to Mulligan concept to improve pain and range of motion.
PROCEDURE	Thoracic Spine Mobilization	Manual mobilization techniques applied to thoracic spine segments to improve thoracic mobility and contribute to shoulder function.
OTHER	Conventional Physiotherapy Program	Conventional physiotherapy program including hot pack application (20 minutes), TENS (80-100 Hz frequency, 50-100 µs impulse duration, 20 minutes), therapeutic ultrasound (1-3 MHz frequency, 1.0-1.5 W/cm² intensity, continuous mode, 7 minutes), and supervised exercise program consisting of pendulum exercises, stick exercises for range of motion, scapular stabilization exercises (retraction, Y-W-T), and progressive strengthening exercises (isometric and dynamic) for rotator cuff muscles.

Timeline

• Start date: 2026-04-20
• Primary completion: 2026-09-20
• Completion: 2026-10-20
• First posted: 2026-04-13
• Last updated: 2026-04-13

Locations

1 site across 1 country: Turkey (Türkiye)