Thoracic Spine Thrust Manipulation Compared to Sham Manipulation in Individuals With Subacromial Pain Syndrome

Sacred Heart University

Status: Completed

Conditions: Subacromial Impingement; Subacromial Impingement Syndrome

Treatments: Procedure: Seated upper thoracic spine thrust manipulation; Procedure: Sham manipulation; Procedure: Supine upper thoracic spine thrust manipulation

Study type: Interventional

Funder types: Other

Identifiers

NCT03109704

151119A

Details and patient eligibility

About

This study evaluates the immediate and short-term effects of a supine upper thoracic spine thrust manipulation, seated upper thoracic spine thrust manipulation, and sham manipulation for individuals with subacromial pain syndrome. The participants were randomized to receive one of the three interventions and baseline measures for the dependent variables were repeated immediately after the delivery of the intervention.

Full description

Thoracic spine thrust manipulation has been shown to be effective in reducing pain and improving function in individuals with subacromial pain syndrome (subacromial impingement). It remains unknown if individuals respond differently to different manipulation techniques. This study examines the immediate effects on pain and short-term effects on pain and function using the Penn Shoulder Score (PSS) as well as the immediate effects on scapular kinematics (upward rotation and posterior tilt, specifically), pectoralis minor muscle length, and scapulothoracic muscle force production for the middle trapezius, lower trapezius, and serratus anterior.

Enrollment: 60 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• currently experiencing shoulder pain for less than 6 months
• at least 3 of the following findings: 1) pain localized to the proximal anterolateral shoulder region, 2) positive Neer or Hawkins-Kennedy impingement test, 3) pain with active shoulder elevation (which may include a painful arc), 4) active shoulder abduction ROM of at least 90°, 5) passive shoulder external rotation ROM of at least 45°, and 6) pain with isometric resisted abduction or external rotation

Exclusion criteria

• signs of a complete rotator cuff tear
• significant loss of glenohumeral motion
• acute inflammation
• cervical spine-related symptoms including a primary complaint of neck pain, signs of central nervous system or cervical nerve root involvement, or reproduction of shoulder or arm pain with cervical rotation, axial compression, or Spurling test
• previous neck or shoulder surgery
• positive apprehension test or relocation test
• history of shoulder fracture or dislocation
• history of nerve injury affecting upper extremity function
• any contraindication for thrust manipulation to the thoracic spine including osteoporosis, fracture, malignancy, systemic arthritis, or infection
• fear or unwillingness to undergo thoracic spine manipulation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 3 patient groups

Supine thrust manipulation

Experimental group

Description:

The supine upper thoracic spine thrust manipulation will be performed two times, regardless of joint cavitation.

Treatment:

Procedure: Supine upper thoracic spine thrust manipulation

Seated thrust manipulation

Experimental group

Description:

The seated upper thoracic spine thrust manipulation will be performed two times, regardless of joint cavitation.

Treatment:

Procedure: Seated upper thoracic spine thrust manipulation

Sham manipulation

Sham Comparator group

Description:

The sham manipulation will be performed two times.

Treatment:

Procedure: Sham manipulation