RecruitingNot ApplicableNCT07546084

The Effect of an Exercise Program Based on Attentional Focus Shifting on Clinical Outcomes in Rotator Cuff Related Shoulder Pain

Sponsor

Istanbul University

Enrollment

46 participants

Start Date

May 15, 2026

Study Type

INTERVENTIONAL

Conditions

Shoulder tendinopathy Shoulder bursitis Subacromial Pain Syndrome Rotator Cuff-related Shoulder Pain Rotator Cuff Tears of the Shoulder

Summary

The aim of this clinical trial is to investigate the effects of an attention shift-based rehabilitation program on clinical outcomes in individuals with rotator cuff-related shoulder pain (RCRSP). The study will evaluate the effects of an attention shift approach, in which motor tasks targeting regions outside the shoulder are performed concurrently with standard shoulder exercises, on pain, functional status, and pain catastrophizing. These results will be compared with those of a standard shoulder rehabilitation program. The main questions this study aims to answer are: Is there a difference in pain levels between individuals with RCRSP who participate in an attention shift-based rehabilitation program and those who participate in a standard exercise program? Is there a difference between these two rehabilitation approaches in terms of shoulder function and pain catastrophizing? Participants will: Be randomly assigned to either an attention shift-based rehabilitation group or a standard shoulder rehabilitation group Participate in supervised exercise sessions twice per week for 6 weeks Attend sessions lasting approximately 60-75 minutes Undergo clinical assessments at baseline and at week 6

Eligibility

Min Age: 18 YearsMax Age: 65 Years

Inclusion Criteria7

Having symptoms persisting for at least 3 months
Experiencing pain intensity of at least 3 on the Numeric Pain Rating Scale (NPRS) during activity
Presence of a painful arc during shoulder flexion or abduction
Positive Neer test or Hawkins-Kennedy test
Pain provoked by resisted external rotation/abduction of the humerus, or a positive Jobe (Empty Can) test
Having a clinical diagnosis of subacromial pain syndrome, rotator cuff tendinopathy, subacromial bursitis, or symptomatic partial/full-thickness rotator cuff tear
Being able to understand and complete questionnaires in Turkish

Exclusion Criteria12

Presence of adhesive capsulitis (≥30% limitation in passive range of motion)
Advanced osteoarthritis of the shoulder
History of fracture or dislocation affecting the shoulder region
Advanced acromioclavicular joint pathology
Massive rotator cuff tear (positive lag signs)
Previous shoulder surgery
Presence of neurological disorders
Diagnosis of rheumatoid arthritis
History of cancer
Symptomatic cervical spine pathology
Corticosteroid injection to the shoulder within the past 6 weeks
Cognitive impairments that may interfere with the ability to perform clinical tasks or execute attention shift-based exercises

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Interventions

OTHERPatient Education

Participants will receive patient education on basic muscle biomechanics, causes of rotator cuff-related shoulder pain, pain management strategies, activity modification, and proper sleeping positions.

OTHERAttention Shift-Based Exercise Therapy

Participants will be enrolled in a structured, supervised shoulder rehabilitation program consisting of exercises recommended in the literature. The program will include a three-phase protocol comprising range of motion exercises, stretching exercises, and strengthening exercises. In addition to the standard shoulder exercise program, participants will perform concurrent motor tasks targeting regions outside the shoulder. These tasks are designed to shift attention away from the painful shoulder region by engaging other body segments (e.g., lower limb or contralateral limb movements performed simultaneously with shoulder exercises). The intervention will be delivered under the supervision of a physiotherapist twice per week over a 6-week period.

OTHERStandard Exercise Therapy

Participants will be enrolled in a structured, supervised standard shoulder rehabilitation program consisting of exercises recommended in the literature. The program will include a three-phase protocol comprising range of motion exercises, stretching exercises, and strengthening exercises. The intervention will focus exclusively on the affected shoulder and will not include any additional cognitive or motor dual-task components or attention-shifting strategies. All exercises will be performed under the supervision of a physiotherapist twice per week over a 6-week period.