Sidi Salem

Subacromial impingement syndrome SAIS is a common cause of shoulder pain caused by narrowing of the space around shoulder tendons, leading to pain, weakness, and limited movement. Muscle weakness, especially in the rotator cuff and scapular muscles, plays an important role. This trial compares two exercise approaches, Blood Flow Restriction BFR training and Pilates exercises, along with conventional therapy, to evaluate their effects on pain, function, movement range, strength, and proprioception in patients with painful SAIS. Participants will be randomly assigned to one of three groups low-load resistance training combined with BFR applied via cuffs on the upper arm, Pilates exercises including mat work and resistance bands, or standard Cools shoulder exercises. Each group will train three times per week for four weeks in 45-minute sessions. Exercises will be progressively adjusted based on participant tolerance and performance. During the study, participants will be assessed at baseline, week 2, and week 4 for shoulder pain and function using SPADI, range of motion, muscle strength, and shoulder proprioception. These measurements will help determine the effectiveness of the exercise methods. The study is sponsored by Cairo University and will run until January 2027.