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

Purpose: This study aimed to compare the effects of proprioceptive neuromuscular facilitation (PNF) and joint mobilization (JM) on shoulder function, acromiohumeral distance (AHD), and pressure pain threshold (PPT) in patients with shoulder impingement syndrome (SIS).Methods: Thirty patients diagnosed with SIS were randomly assigned to either a PNF group (n = 15) or a JM group (n = 15).Both groups received conventional rehabilitation with additional PNF or JM techniques for 6 weeks (3 sessions/week).Shoulder function was assessed using the Shoulder Pain and Disability Index (SPADI), structural changes were measured via AHD, and pain sensitivity was evaluated using PPT.Two-way repeated-measures ANOVA with post-hoc analyses was performed.Results: Both interventions significantly improved all outcome measures.The PNF group demonstrated superior improvements in SPADI (p < 0.05) and PPT (p < 0.05), indicating enhanced functional recovery and reduced pain sensitivity.The JM group showed greater increases in AHD, suggesting more effective subacromial space restoration.Significant group time interactions were observed for SPADI and PPT. Conclusion:Both PNF and JM were effective for SIS management, with distinct therapeutic advantages.PNF showed superior effects on functional recovery and pain modulation, while JM was more effective for structural space restoration.