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Soleimanifar M, Sarabzadeh M, Pakdel M, Asadi Z S. Effects of 8-Week Aquatic Training on Pain, Range of Motion, and Muscle Activity in Older Adults With Shoulder Impingement Syndrome: A Randomized Controlled Trial. PTJ 2026; 16 (S1) :433-444
URL: http://ptj.uswr.ac.ir/article-1-717-en.html

Purpose: Shoulder impingement syndrome (SIS) is the most prevalent issue among shoulder disorders. Given the promising outcomes of aquatic physiotherapy in rehabilitation, this study aimed to evaluate the impact of an 8-week aquatic training program on pain, range of motion (ROM), and electrical activity in the shoulder of older adults suffering from SIS.
Methods: A total of 30 male military retirees aged 60 years and older were voluntarily recruited and then randomly assigned to the experimental and control groups. The experimental group participated in an eight-week aquatic training program. Pain, ROM, and shoulder muscle activity were investigated using a visual analog scale (VAS), an electrogoniometer, and electromyography (EMG), respectively—twice: pre-test and post-test. 
Results: Results showed significant differences between groups in pain scale, shoulder external (ER) and internal rotation (IR) (P<0.001), shoulder abduction (P=0.002), and muscle electrical activity of serratus anterior (P<0.001), but not in shoulder flexion (P=0.082) and muscle activity of upper trapezius (P=0.075). 
Conclusion: Our aquatic training program may profoundly impact shoulder ROM recovery and shoulder pain relief in patients with SIS. Further research is warranted to assess different and more specialized aquatic programs to improve shoulder flexion and trapezius muscle function, which were not improved by the present intervention.