Effects of Different Kinesio Taping Methods in Subacromial Impingement Syndrome

This prospective, randomized controlled trial aims to compare the effects of two different kinesio taping techniques on pain, shoulder function, acromiohumeral distance, and shoulder proprioception in patients with subacromial impingement syndrome. A total of 72 patients aged 18-65 years diagnosed with subacromial impingement syndrome will be randomly assigned to three groups: (1) conventional shoulder kinesio taping combined with therapeutic exercise, (2) scapular kinesio taping combined with therapeutic exercise, and (3) therapeutic exercise alone (control group). All participants will receive the same supervised therapeutic exercise program three times per week for eight weeks, totaling 24 sessions. Participants in the two kinesio taping groups will additionally receive their respective taping interventions three times per week for eight weeks. Outcome assessments will be performed at baseline and after eight weeks of treatment by an assessor blinded to group allocation. The primary outcome will be acromiohumeral distance measured by ultrasonography at 0° and 60° of shoulder abduction. Secondary outcomes will include pain intensity assessed using the Visual Analog Scale (VAS), shoulder pain and disability assessed using the Shoulder Pain and Disability Index (SPADI), health-related quality of life assessed using the Western Ontario Rotator Cuff Index (WORC), and shoulder proprioception assessed using an active joint repositioning test. The study aims to determine whether adding kinesio taping to therapeutic exercise provides additional benefits and whether the effects differ between conventional shoulder and scapular taping techniques.

Inclusion Criteria: \- 1. Age between 18 and 65 years. 2. Shoulder pain persisting for at least 6 weeks. 3. Presence of a painful arc during shoulder flexion or abduction. 4. Positive Neer or Hawkins-Kennedy test. 5. Pain during at least one of the following tests: resisted shoulder external rotation, resisted abduction, or Jobe/Empty Can test. 6\. Ability to understand the study procedures. 7. Voluntary agreement to participate in the study and adhere to the treatment program. Exclusion Criteria: * 1\. History of shoulder surgery. 2. History of fracture involving the shoulder girdle. 3. Traumatic onset of shoulder pain. 4. Full-thickness or massive rotator cuff tear. 5. Significant tear of the long head of the biceps tendon. 6. Adhesive capsulitis. 7. History of glenohumeral instability or dislocation. 8. Cervical radiculopathy that may explain shoulder symptoms or pain provoked by cervical movements. 9\. Neurological or systemic rheumatological disease that may affect shoulder function. 10\. Open wounds or active dermatological lesions in the area of kinesio tape application. 11\. Known allergy or intolerance to kinesio tape or adhesive materials. 12. Physical therapy or injection treatment to the affected shoulder within the previous 6 months. 13\. Pregnancy.