Effects of Vibration-Based and Instrument-Assisted Myofascial Interventions on Proprioception, Pain, Functional Disability, and Quality of Life in Individuals with Subacromial Impingement Syndrome: A Randomized Controlled Trial

Methods

Forty-two participants with MRI-confirmed SIS completed a 4-week intervention and were analyzed (n=14/group). All groups received a conventional physiotherapy programme; the PMT and IASTM groups additionally received their respective interventions 3 times/week. Primary outcomes were JPS in shoulder flexion and abduction assessed using the Becure Extremity ROM system.

Secondary outcomes included ROM (flexion, abduction, internal/external rotation), pain intensity (VAS-resting and VAS-activity), disability (DASH), and quality of life (RC-QoL). Between-group post-intervention comparisons used ANCOVA adjusted for baseline values. Results: All groups showed significant pre–post improvements (p≤0.047).

After adjustment, a significant between-group effect was found for JPS in flexion (F=5.76, p=0.007, η²p=0.23), with greater improvements in PMT and IASTM versus conventional therapy (PMT vs CT p=0.021; IASTM vs CT p=0.004), and no difference between PMT and IASTM. JPS in abduction did not differ between groups (p=0.169). Significant between-group effects were observed for ROM, VAS (resting and activity), DASH, and RC-QoL (all p<0.001), generally favoring adjunct interventions; RC-QoL also favored PMT over IASTM (p=0.031).

Conclusion: Adding PMT or IASTM to conventional physiotherapy provides additional benefits in SIS, particularly for JPS in flexion, ROM, pain, disability, and rotator cuff–related quality of life; PMT yielded greater quality-of-life gains than IASTM. Keywords: subacromial impingement syndrome; percussion massage therapy; instrument-assisted soft tissue mobilization; joint position sense.