Effects of Combined PNF and Joint Mobilization on Shoulder Function, Acromiohumeral Distance, and Pressure Pain Threshold in Patients with Subacromial Impingement Syndrome: A Randomized Controlled Trial

PURPOSE: To investigate the combined effects of proprioceptive neuromuscular facilitation (PNF) and joint mobilization on shoulder function, acromiohumeral distance (AHD), pressure pain threshold (PPT), and muscle activity in patients with subacromial impingement syndrome.METHODS: Thirty patients with subacromial impingement syndrome were randomly assigned to an experimental group (conventional rehabilitation plus PNF and joint mobilization, n=15) or a control group (conventional rehabilitation plus joint mobilization, n=15). Interventions were administered 5 times per week for 4 weeks. Outcome measures included the Shoulder Pain and Disability Index (SPADI), AHD, PPT, and surface electromyographic activity of the upper and lower trapezius and serratus anterior muscles.RESULTS: Both groups exhibited significant within-group improvements in SPADI, PPT, and muscle activity (p