Comparative Effects of Cervicothoracic Junction Mobilization and Thoracic Manipulation in Subachromial Impinegment Syndrome

NCT06110039 | Unknown

• 1 other identifier: S22C14G30039
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to investigate the comparative effects of high velocity low amplitude thrust manipulation of upper thoracic spine and spinal mobilization with arm movement on the subjects with the subacromial impingement syndrome.

Conditions

Subacromial Impingement Syndrome

Keywords

shoulder pain; NECK PAIN; UPPER THORACIC MOBILIZATION; CERVICOTHORACIC MOBILIZATION; SUBACROMIAL IMPIGEMENT SYNDROME

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale (NPRS)

  NPRS scale will be used to quantify pain intensity levels. The scale ranges from '0' for the least amount of pain "no pain" to '10' for the most extreme levels of pain "pain as severe as you can imagine". It is convenient to use NPRS for patients. Its score ranges between 0-10 (19). It is a valid and reliable tool (20). Reliability ranges from .67-.96 and validity ranges from 0.79-0.95

  6 weeks

• Shoulder pain and disability index SPADI

  To quantify the degree to which patients affected with shoulder pain may have disability the Shoulder Pain and Disability Index (SPADI) was created. The SPADI's 13 components are split between a pain scale of five items and a disability scale of eight items. The numerical rating scale variant was created to facilitate its use and scoring (23). Reliability of SPADI is 0.92 and validity is 0.79

  6 weeks

• imagej software

  It can calculate area and pixel value statistics of user-defined selections. It can measure distances and angles. It can create density histograms and line profile plots. It supports standard image processing functions such as contrast manipulation, sharpening, smoothing, edge detection and median filtering.. It has been introduced as a reliable assessment tool.

  6 weeks

Study Arms (2)

Group 1: Cervicothoracic junction mobilization with arm movement along with baseline treatment

EXPERIMENTAL

Other: Cervicothoracic Junction Mobilization

Group 2: upper thoracic manipulation woth baseline treatment

EXPERIMENTAL

Other: Upper Thoracic Spine Manipulation:

Interventions

Cervicothoracic Junction Mobilization OTHER

The therapist stood in back of the subject, who was seated straight on a chair. The therapist positioned the medial side of one hand's thumb. The desired level of vertebra can be strengthened by placing the index finger of the opposite hand on the spinous process. A pure transverse glide was executed from the affected side to the unaffected side.

Group 1: Cervicothoracic junction mobilization with arm movement along with baseline treatment

Upper Thoracic Spine Manipulation: OTHER

The therapist placed one hand on the patient's head and the hypothenar or thenar eminence of the other hand was placed over the T1 transverse process (the therapist's left hand was used for thrusting and vice versa for treating the left T1 Transverse process). As the tissue deficiency is taken up localizing the forces, the patient was urged to breathe in and out multiple times. While holding the hand on the head steady, a minor relative rotation in the opposite direction was caused, which led to the introduction of the postero-anterior force on the transverse process of T1(29). Patients will receive three sessions a week on alternate days for three weeks and follow up data will be taken once after completion of all three sessions using data collection tools

Group 2: upper thoracic manipulation woth baseline treatment

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age ranging from 18-40
• Both males and Females
• Positive Hawkins and Neer's impingement test positive
• The subjects primarily report unilateral shoulder pain.

You may not qualify if:

• Patients with diagnosed case of co morbidities such as malignancies, RA, or fracture, that causes bilateral shoulder discomfort.
• Diagnosed case of cervical radiculopathy, glenohumeral osteoarthritis, and adhesive capsulitis

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Johar pain relief center

Lahore, Punjab Province, 54000, Pakistan

RECRUITING

Related Publications (8)

• Lo YP, Hsu YC, Chan KM. Epidemiology of shoulder impingement in upper arm sports events. Br J Sports Med. 1990 Sep;24(3):173-7. doi: 10.1136/bjsm.24.3.173.

  PMID: 2078803 BACKGROUND

• Kardouni JR, Shaffer SW, Pidcoe PE, Finucane SD, Cheatham SA, Michener LA. Immediate changes in pressure pain sensitivity after thoracic spinal manipulative therapy in patients with subacromial impingement syndrome: A randomized controlled study. Man Ther. 2015 Aug;20(4):540-6. doi: 10.1016/j.math.2014.12.003. Epub 2014 Dec 22.

  PMID: 25595413 BACKGROUND

• Michener LA, Kardouni JR, Sousa CO, Ely JM. Validation of a sham comparator for thoracic spinal manipulation in patients with shoulder pain. Man Ther. 2015 Feb;20(1):171-5. doi: 10.1016/j.math.2014.08.008. Epub 2014 Sep 6.

  PMID: 25261090 BACKGROUND

• McCoy RC, Bittencourt E, Clifton W. Cervicothoracic Manipulation Techniques Reviewed Utilizing Three-Dimensional Spine Model. Cureus. 2019 Oct 4;11(10):e5836. doi: 10.7759/cureus.5836.

  PMID: 31754571 BACKGROUND

• McDevitt A, Young J, Mintken P, Cleland J. Regional interdependence and manual therapy directed at the thoracic spine. J Man Manip Ther. 2015 Jul;23(3):139-46. doi: 10.1179/2042618615Y.0000000005.

  PMID: 26309384 BACKGROUND

• Joshi S, Balthillaya G, Neelapala YVR. Immediate effects of cervicothoracic junction mobilization versus thoracic manipulation on the range of motion and pain in mechanical neck pain with cervicothoracic junction dysfunction: a pilot randomized controlled trial. Chiropr Man Therap. 2020 Aug 7;28(1):38. doi: 10.1186/s12998-020-00327-4.

  PMID: 32762708 BACKGROUND

• Hunter DJ, Rivett DA, McKiernan S, Luton R, Snodgrass SJ. Thoracic Manual Therapy Improves Pain and Disability in Individuals With Shoulder Impingement Syndrome Compared With Placebo: A Randomized Controlled Trial With 1-Year Follow-up. Arch Phys Med Rehabil. 2022 Aug;103(8):1533-1543. doi: 10.1016/j.apmr.2022.03.003. Epub 2022 Mar 21.

  PMID: 35331719 BACKGROUND

• Hegarty AK, Hsu M, Roy JS, Kardouni JR, Kutch JJ, Michener LA. Evidence for increased neuromuscular drive following spinal manipulation in individuals with subacromial pain syndrome. Clin Biomech (Bristol). 2021 Dec;90:105485. doi: 10.1016/j.clinbiomech.2021.105485. Epub 2021 Sep 21.

  PMID: 34571486 BACKGROUND

MeSH Terms

Conditions

Shoulder Impingement Syndrome; Shoulder Pain; Neck Pain

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries; Arthralgia; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Ali raza

  Riphah International University

  PRINCIPAL INVESTIGATOR

• Mehreen Mazhar

  Riphah inernational university

  PRINCIPAL INVESTIGATOR

Central Study Contacts

imran amjad, phd

CONTACT

+923324390125; imran.amjad@riphah.edu.pk

imran amjad, phd

CONTACT

051-5481826; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 25, 2023
• First Posted: October 31, 2023
• Study Start: May 10, 2023
• Primary Completion: December 10, 2023
• Study Completion: January 10, 2024
• Last Updated: October 31, 2023

Record last verified: 2023-10

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)