title: The effectiveness of manual therapy in supraspinatus tendinopathy.
abstract: OBJECTIVE
  The aim of this randomized controlled study was to assess the efficacy of manual therapy in the treatment of patients with symptomatic supraspinatus tendinopathy.
  
  
  METHODS
  Seventy-seven patients (age range, 30 to 55 years) with supraspinatus tendinopathy, were randomly assigned to one of the three treatment groups: a supervised exercise program (Group 1), a supervised exercise program combined with joint and soft tissue mobilization (Group 2), or a home-based rehabilitation program (Group 3). All patients had rehabilitation for 12 weeks. Pain level was evaluated with a visual analogue scale (VAS) and the range of motion (ROM) was measured with a goniometer. The Modified American Shoulder and Elbow Surgery (MASES) score was used in functional assessment. Flexion, abduction, internal and external rotation strengths were measured with a manual muscle test. All patients were evaluated before, and at the 4th and 12th week of the rehabilitation.
  
  
  RESULTS
  All groups experienced significant decrease in pain and an increase in shoulder muscle strength and function by both the 4th and 12th weeks of treatment (p<0.05). There was no significant difference between the groups in terms of function (p>0.05). However, the greatest improvement in functionality was found in Group 2.
  
  
  CONCLUSIONS
  Supervised exercise, supervised and manual therapy, and home-based exercise are all effective and promising methods in the rehabilitation of the patients with subacromial impingement syndrome. The addition of an initial manual therapy may improve the results of the rehabilitation with exercise.
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Medical Sciences, Hacettepe University, Ankara, Turkey. gamzesenbursa@yahoo.com
authors.forename: Gamze
authors.initials: G
authors.lastname: Şenbursa
authors.forename: Gül
authors.initials: G
authors.lastname: Baltaci
authors.forename: Ö Ahmet
authors.initials: ÖA
authors.lastname: Atay
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D010146:Pain / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D020127:Recovery of Function; D017006:Rotator Cuff / Q000503:physiopathology; D012782:Shoulder / Q000503:physiopathology; D019534:Shoulder Impingement Syndrome / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D052256:Tendinopathy / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome