Short-term Effects of Thoracic Manipulation in Shoulder Impingement

NCT02083796 | Completed

• 2 other identifiers: Haik-0607Ethics Committee 465/2011
• Study Type: interventional
• Target: 110
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Shoulder Impingement Syndrome

Keywords

manual therapy; rehabilitation; shoulder; spine

Outcome Measures

Primary Outcomes (1)

• Change in scapular orientation from first to third day

  3D scapular kinematic (upward/downward rotation; internal/external rotation; anterior/posterior tilt) was assessed pre- and-post thoracic spinal manipulation and sham interventions at first and second days. At the third day of evaluation the measure was assessed only once.

  Day 1; day 2; day 3

Secondary Outcomes (3)

• Change in shoulder function from first to third day

  Day 1; Day 2; Day 3

• Change in scapular muscle activity from first to third day

  Day 1; Day 2; Day 3

• Change in shoulder pain from first to third day

  Day 1; Day 2; Day 3

Study Arms (4)

Shoulder impingement_TSM

EXPERIMENTAL

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.

Procedure: Shoulder impingement_TSM

Shoulder impingement_sham

SHAM COMPARATOR

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.

Procedure: Shoulder impingement_sham

Asymptomatic_TSM

ACTIVE COMPARATOR

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

Procedure: Asymptomatic_TSM

Asymptomatic_sham

SHAM COMPARATOR

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.

Procedure: Asymptomatic_sham

Interventions

Shoulder impingement_TSM PROCEDURE

A physiotherapist with 4 years of experience in manual therapy will administer the TSM targeting the middle thoracic spine of the subjects.

Also known as: Spine manipulation, Spinal manipulation, (Spinal) Thrust

Shoulder impingement_TSM

Asymptomatic_TSM PROCEDURE

A physiotherapist with 4 years of experience in manual therapy administered the TSM targeting the middle thoracic spine of the subjects.

Also known as: Spine manipulation, Spinal manipulation, (Spinal) Thrust

Asymptomatic_TSM

Shoulder impingement_sham PROCEDURE

A physiotherapist with 4 years of experience in manual therapy administered the sham intervention targeting the middle thoracic spine of the subjects.

Also known as: Sham spinal manipulation

Shoulder impingement_sham

Asymptomatic_sham PROCEDURE

A physiotherapist with 4 years of experience in manual therapy administered the sham intervention targeting the middle thoracic spine of the subjects.

Also known as: Sham spinal manipulation

Asymptomatic_sham

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• 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.

You may not qualify if:

• 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.
• 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

Sponsors & Collaborators

• Universidade Federal de Sao Carlos: lead
• Fundação de Amparo à Pesquisa do Estado de São Paulo: collaborator

Study Sites (1)

Universidade Federal de São Carlos

São Carlos, São Paulo, 13565-905, Brazil

Location

Related Publications (1)

• Haik MN, Alburquerque-Sendin F, Camargo PR. Short-Term Effects of Thoracic Spine Manipulation on Shoulder Impingement Syndrome: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2017 Aug;98(8):1594-1605. doi: 10.1016/j.apmr.2017.02.003. Epub 2017 Mar 1.

  PMID: 28259517 DERIVED

MeSH Terms

Conditions

Shoulder Impingement Syndrome

Interventions

Manipulation, Spinal

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Musculoskeletal Manipulations; Physical Therapy Modalities; Therapeutics; Rehabilitation

Study Officials

• Paula R Camargo, doctor

  Universidade Federal de Sao Carlos

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Master

Study Record Dates

• First Submitted: February 4, 2014
• First Posted: March 11, 2014
• Study Start: July 1, 2013
• Primary Completion: July 1, 2015
• Study Completion: July 1, 2015
• Last Updated: October 27, 2015

Record last verified: 2015-10

Locations

BR (1)