EFFECTS OF TELE REHABILITATION WITH AND WITHOUT MULLIGAN TECHNIQUE ON PAIN, RANGE OF MOTION AND FUNCTIONAL DISABILITY IN PATIENTS OF SUBACROMIAL PAIN SYNDROME.

Background: Subacromial pain syndrome is a common cause of shoulder pain and activity limitation, frequently affecting shoulder mobility, daily function and quality of life. Conservative rehabilitation remains the preferred management approach, while telerehabilitation has increased access to supervised care through remote platforms. The Mulligan technique may provide additional benefit by promoting pain-free movement and improving joint mechanics. Evidence comparing telerehabilitation with and without self-Mulligan technique in subacromial pain syndrome remains limited. Objective: To compare the effects of telerehabilitation combined with self-Mulligan technique versus telerehabilitation alone on pain intensity, shoulder range of motion and functional disability in patients with subacromial pain syndrome. Methods: A randomized controlled trial was conducted at Pakistan Rugby Academy, Lahore, over nine months. A sample size of 58 was calculated, and 52 participants completed the study. Participants were recruited through purposive sampling and randomly allocated into two equal groups using a computer-generated sequence with allocation concealment. Group A received telerehabilitation with self-Mulligan technique, while Group B received telerehabilitation alone. Pain was assessed using the Visual Analogue Scale, shoulder range of motion using a digital goniometer, and functional disability using SPADI and QuickDASH. Data were analyzed using appropriate non-parametric tests, with p < 0.05 considered significant. Results: The study included 52 participants, with 26 in each group. Baseline gender distribution (p = 0.248) and affected side (p = 0.510) were comparable. Mean age was 34.08 ± 9.299 years. Overall VAS decreased from 7.56 ± 1.195 to 4.58 ± 1.775. Flexion improved from 114.25 ± 17.266° to 143.44 ± 21.685°, extension from 29.00 ± 6.023° to 40.13 ± 7.170°, abduction from 106.38 ± 15.017° to 135.13 ± 20.026°, internal rotation from 44.71 ± 9.187° to 60.10 ± 11.328°, and external rotation from 42.40 ± 9.179° to 57.10 ± 11.323°. SPADI reduced from 74.10 ± 9.910 to 50.94 ± 13.068, and QuickDASH from 63.27 ± 8.997 to 43.10 ± 11.776. Group A showed significantly better post-intervention outcomes than Group B for all variables. Conclusion: Telerehabilitation was effective in improving pain, shoulder mobility and functional disability in patients with subacromial pain syndrome. However, adding self-Mulligan technique produced superior clinical outcomes, supporting its use as an accessible and patient-centered rehabilitation strategy. Keywords: Disability Evaluation; Exercise Therapy; Musculoskeletal Pain; Range of Motion, Articular; Shoulder Impingement Syndrome; Telerehabilitation; Visual Analog Scale.