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Randomized Controlled Trial
. 2024 Dec;32(6):584-593.
doi: 10.1080/10669817.2024.2341453. Epub 2024 Apr 15.

Efficacy of Mulligan thoracic sustained natural apophyseal glides on sub-acromial pain in patients with sub-acromial impingement syndrome: a single-blinded randomized controlled trial

Shimaa T Abu El Kasem  1   2 , Fatma Alzahraa A Alaa  3 , Neveen A Abd El-Raoof  1 , Alshaymaa S Abd-Elazeim  1
Affiliations
Randomized Controlled Trial

Efficacy of Mulligan thoracic sustained natural apophyseal glides on sub-acromial pain in patients with sub-acromial impingement syndrome: a single-blinded randomized controlled trial

Shimaa T Abu El Kasem et al. J Man Manip Ther. 2024 Dec.

Abstract

Purpose: To investigate the effects of Mulligan thoracic sustained natural apophyseal glides (SNAGS) techniques and traditional exercises on pain, shoulder function, size of sub-acromial space, and shoulder joint range in patients with sub-acromial impingement syndrome.

Methods: Seventy-four patients with sub-acromial impingement syndrome (25 to 40 years) joined this research and were allocated randomly into two equal groups; experimental group A (Mulligan SNAGS and exercise) and control group B (exercise only). All patients were assessed by visual analogue scale (VAS) for pain intensity, Shoulder Pain and Disability Index (SPADI) for shoulder function, plain x-ray for the size of sub-acromial space, and goniometer for shoulder range of motion (ROM). The measurements were performed at two intervals (baseline and after four weeks of intervention).

Results: After 4 weeks of intervention, there were statistically significant differences between groups, in favor of Mulligan SNAGS, on sub acromial space size, pain intensity, shoulder function, and shoulder joint range of motion (p < 0.05). In within-group analysis, there were also statistically significant differences between pre- and post-treatment in all measured variables (p < 0.05).

Conclusion: Mulligan thoracic spine (SNAGS) mobilization into extension and traditional exercises improve sub acromial space size, pain intensity, shoulder function, and shoulder joint range of motion in patients with sub acromial impingement syndrome. It is recommended to mobilize the thoracic spine by mulligan SNAGS in the treatment of sub-acromial impingement syndrome.

Keywords: Sub-acromial pain; impingement syndrome; size of sub-acromial space; thoracic spine SNAGS.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Thoracic SNAGS extension.
Figure 2.
Figure 2.
Sub-acromial space before and after treatment.
Figure 3.
Figure 3.
CONSORT flow chart.
See this image and copyright information in PMC

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