Short-term Effects of Thoracic Manipulation in Shoulder Impingement

Universidade Federal de Sao Carlos

Status: Completed

Conditions: Shoulder Impingement Syndrome

Treatments: Procedure: Asymptomatic_sham; Procedure: Shoulder impingement_TSM; Procedure: Asymptomatic_TSM; Procedure: Shoulder impingement_sham

Study type: Interventional

Funder types: Other

Identifiers

NCT02083796

Ethics Committee 465/2011 (Other Grant/Funding Number)

Haik-0607

Details and patient eligibility

About

The hypothesis of this study is that thoracic spine manipulation would reduce pain in subjects with SIS and cause changes in scapular kinematics and muscle activity in subjects with impingement symptoms and in asymptomatic subjects. With this study, the investigators want to answer if possible changes in scapular motion and muscle activity following a TSM depend on the symptoms or if it is generic to individuals without shoulder dysfunction and not specific to subjects with shoulder impingement.

Full description

Subjects with shoulder impingement signs will be evaluated and will be compared with subjects asymptomatic for shoulder symptoms. Both subjects will be randomly assigned to one of two intervention groups: thoracic spinal manipulation (TSM) or sham intervention. We want to know if possible changes in scapular motion and muscle activity following a TSM depend on the symptoms or if it is generic to everyone. Also, we want to know if TSM reduces shoulder pain immediately and in a short-therm period.

Enrollment: 110 patients

Sex: All

Ages: 18 to 40 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria (symptomatic subjects): To present with at least 3 of the following findings:

• positive Neer impingement test,
• positive Hawkins impingement test,
• positive Jobe test,
• pain with passive or isometric resisted shoulder lateral rotation,
• pain with active shoulder elevation,
• pain with palpation of rotator cuff tendons,
• pain in the C5 or C6 dermatome region.

Exclusion Criteria (symptomatic subjects):

• signs of "red flags" for spinal manipulation (eg, fracture, osteoporosis, malignancy, infection, and active inflammatory process),
• pregnancy
• systemic illnesses
• if received physical therapy or manual therapy treatment within the 6 months prior to the evaluation
• signs of complete rotator cuff tear or acute inflammation
• cervical-thoracic spine related symptoms (ie, positive cervical compression test and excessive kyphosis)
• scoliosis
• glenohumeral instability (ie, positive apprehension, anterior drawer, or sulcus tests)
• previous upper extremity fracture or shoulder surgery.

Exclusion Criteria (asymptomatic subjects):

• any positive test for shoulder impingement
• signs of "red flags" for spinal manipulation (eg, fracture, osteoporosis, malignancy, infection, and active inflammatory process),
• pregnancy
• systemic illnesses
• if received physical therapy or manual therapy treatment within the 6 months prior to the evaluation
• signs of complete rotator cuff tear or acute inflammation
• cervical-thoracic spine related symptoms (ie, positive cervical compression test and excessive kyphosis)
• scoliosis
• glenohumeral instability (ie, positive apprehension, anterior drawer, or sulcus tests)
• previous upper extremity fracture or shoulder surgery.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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110 participants in 4 patient groups

Shoulder impingement_TSM

Experimental group

Description:

For the manipulation intervention, the subjects were in a seated position and a thrust technique was performed. If no cavitation was detected with the manipulation, the thrust was repeated up to 3 times.

Treatment:

Procedure: Shoulder impingement_TSM

Shoulder impingement_sham

Sham Comparator group

Description:

For the sham intervention, the subjects were positioned in the same seated position with the therapist holding the patient in the same position as for the thrust manipulation. In this position, the therapist applied all the same forces as done for a thrust-manipulation and held that position for a few seconds, but a thrust was not used.

Treatment:

Procedure: Shoulder impingement_sham

Asymptomatic_TSM

Active Comparator group

Description:

For the manipulation intervention, the subjects were in a seated position and a thrust technique was performed. If no cavitation was detected with the manipulation, the thrust was repeated up to 3 times

Treatment:

Procedure: Asymptomatic_TSM

Asymptomatic_sham

Sham Comparator group

Description:

For the sham intervention, the subjects were positioned in the same seated position with the therapist holding the patient in the same position as for the thrust manipulation. In this position, the therapist applied all the same forces as done for a thrust-manipulation and held that position for a few seconds, but a thrust was not used.

Treatment:

Procedure: Asymptomatic_sham