Combined Effects of Manual Therapy on the Shoulder

NCT04777370 | Completed

• 1 other identifier: PRO2021000105
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Interventions including glenohumeral mobilization, sleeper stretches, and thoracic manipulation have been proposed for individuals with loss of shoulder range of motion (ROM). However, the effect of these interventions on shoulder ROM, joint translation, and muscular activity have not been studied in combination.

Conditions

Range of Motion; Manual Therapies; Shoulder Joint Disorder

Keywords

shoulder; Glenohumeral Internal Rotation Deficit (GIRD); joint play; muscular activity

Outcome Measures

Primary Outcomes (3)

• Change in shoulder IR ROM

  Shoulder IR ROM measured with a goniometer

  Pre intervention to immediate (within 5 minutes) post intervention

• Change in posterior shoulder translation (mm)

  maximum posterior translation of the humeral head assessed with ultrasound imaging (mm)

  Pre intervention to immediate (within 5 minutes) post intervention

• Change in infraspinatus electromyographic activity (%MVIC)

  activity of the infraspinatus muscle during posterior translation, assessed as a percentage of the maximal voluntary isometric contraction (MVIC)

  Pre intervention to immediate (within 5 minutes) post intervention

Study Arms (2)

sleeper stretch + thoracic manipulation

EXPERIMENTAL

The group will receive the sleeper stretch at session #1, and a thoracic manipulation followed by the sleeper stretch at session #2.

Other: Sleeper stretch; Other: thoracic manipulation

posterior glenohumeral (PG) mobilization + thoracic manipulation

EXPERIMENTAL

The group will receive a posterior glide mobilization at session #1, and a thoracic manipulation followed by posterior glide mobilization at session #2.

Other: posterior glide mobilization; Other: thoracic manipulation

Interventions

posterior glide mobilization OTHER

The participant will be positioned supine on a plinth, with their scapula stabilized against a firm wedge on the table, and the shoulder joint in the resting position (approx. 55 degrees abduction, 30 degrees horizontal adduction, and slight external rotation). With the extremity held in the same position, the researcher will then apply a grade III (into tissue stretch) PG mobilization. This will consist of five 30-second bouts of sustained gr III posterior glide mobilizations.

posterior glenohumeral (PG) mobilization + thoracic manipulation

Sleeper stretch OTHER

All participants randomized to the stretching group will perform five 30-second holds of the sleeper stretch. This is performed by lying on the side to be stretched, elevating the upper arm to 90° on the support surface with the elbow bent 90°, then passively internally rotating the shoulder with force provided by with the opposite arm.

sleeper stretch + thoracic manipulation

thoracic manipulation OTHER

Individuals will then undergo a single supine grade V thrust manipulation. All manipulations will take place at the T3-4 segment. If a cavitation ("pop") is not heard or felt by either the subject or examiner, a second thrust will be performed.

posterior glenohumeral (PG) mobilization + thoracic manipulation; sleeper stretch + thoracic manipulation

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• loss of IR of 15 degrees of greater compared to contralateral shoulder

You may not qualify if:

• currently neck/upper back pain,
• history of spinal fractures,
• numbness/altered sensation of the arms or legs,
• whiplash injury within the prior 6 weeks,
• infections of the spine,
• currently pregnant/possibly pregnant,
• known osteoporosis,
• Rheumatoid arthritis,
• previous spine surgery,
• currently receiving Workman's Compensation,
• any pending litigation regarding a neck or shoulder injury,
• history of oral corticosteroids in the prior 6 months,
• history of shoulder fractures,
• Current treatment for cancer,
• Prior history of cancer involving the spine/shoulder,

Sponsors & Collaborators

• University of Hartford: lead

Study Sites (1)

University of Hartford

West Hartford, Connecticut, 06117, United States

Location

Study Officials

• Brian Swanson, PT, DSc

  University of Hartford

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Assessment of electromyographic (EMG) activity, IR ROM pre-post intervention, and glenohumeral translation via ultrasound will be performed by a blinded assessor.
• Purpose: TREATMENT
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: All participants will undergo a single intervention during the first session, and then combined thoracic manipulation and a repeat of the prior intervention at the second session.

Study Record Dates

• First Submitted: February 22, 2021
• First Posted: March 2, 2021
• Study Start: March 31, 2021
• Primary Completion: June 30, 2021
• Study Completion: June 30, 2021
• Last Updated: July 7, 2021

Record last verified: 2021-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)