Effects of Adding Thoracic Extension Exercises or Thoracic Kinesio Taping to Shoulder Exercises on Pain and Function in Adults with Subacromial Pain Syndrome: A Randomized Controlled Trial.

Abstract

In subacromial pain syndrome (SAPS), a common cause of shoulder pain, thoracic spine targeted interventions have been associated with improvements in shoulder outcomes. This study aimed to investigate the effects of adding thoracic extension exercises (TEE) or thoracic kinesio taping (KT) to shoulder exercises (SE) on shoulder pain, disability, active range of motion (AROM), and strength in adults with SAPS. Seventy-five adults with SAPS were randomized into three groups. Group A and Group B received TEE and KT in addition to SE, respectively, while Group C received only SE. All exercises were performed five days a week for three weeks. KT was applied every three days, for a total of five applications. Assessments included shoulder pain intensity (Visual Analog Scale, VAS), pressure pain threshold (PPT) of the upper trapezius and pectoralis major (algometer), self-reported disability (Disabilities of the Arm, Shoulder, and Hand, DASH) and health status (Short Form-36), AROM (universal goniometer), isometric strength of the shoulder (hand-held dynamometer), and thoracic kyphosis (inclinometer). Pain decreased by approximately 3.1-4.4 cm on the VAS, DASH scores improved by 20-23 points, and shoulder AROM increased by 7-50° across groups (p<0.05). PPT increased by 2.7-7.2 kg/cm² in measures showing statistically significant improvement (p<0.05). Isometric shoulder strength increased in Groups A and B (p<0.05), whereas no significant strength changes were observed in Group C (p>0.05). Between-group comparisons demonstrated greater improvements in PPT of the pectoralis major and shoulder abductor and adductor strength in the groups receiving thoracic interventions compared with SE alone (p<0.05). Although all interventions improved most outcomes, adding TEE or KT to SE resulted in greater improvements in pain sensitivity and shoulder muscle strength, with no superiority between TEE and KT. Longer-term studies are warranted. Level II, Randomized Controlled Trial, Treatment Study.