RESUMEN
The objective of our work is to compare between the use of combined effect of mobilization technique and therapeutic exercises versus therapeutic exercises as regard pain functional disability at the shoulder and motion in case pf supraspinatus, impingment syndrome. Thirty patients diagnosed as shoulder impingement syndrome [SIS] due to functional causes [stage II Neer classification] participated in this study. Patients were randomly distributed into two groups. The first group consisted of 15 patients with a mean age 36.47 [ +/- 6.68], they received infrared radiation followed by a program of therapeutic exercises. The second group consisted of 15 patients with a mean age 36.26 [ +/- 6.54], they received infrared radiation followed by a combined program of mobilization techniques and therapeutic exercises. Treatment was given 3 times per week, each other day, for 4 consecutive weeks. Patients were evaluated pretreatment and posttreatment for shoulder pain severity, shoulder functional disability, shoulder flexion, abduction and internal rotation motions as well as for the acromiohumeral distance in adduction and abduction using ultrasonography. Both groups of patients showed significant improvement in all the measured variables. There was a significant reduction of both shoulder pain severity and functional disability as well as significant increase of shoulder flexion, abduction and internal rotation motions. In addition to that there was also a significant increase in the acromiohumeral distance in adduction and abduction. However the combination of mobilization and therapeutic exercises was more effective than the therapeutic exercises alone in improving the measured variables. Use of a combined program of mobilization and therapeutic exercises is more significantly effective than therapeutic exercises in treatment of shoulder impingement syndrome