Manual Therapy in Chronic Shoulder Pain Treatment

Not Applicable

Completed

• Conditions: Shoulder Pain
• Interventions: Procedure: The manual contact condition; Procedure: Mobilization to the glenohumeral joint; Other: No-contact condition

• Registration Number: NCT03416556
• Lead Sponsor: University of Alcala

Brief Summary

Background: Passive oscillatory mobilizations are often employed by physiotherapists to reduce shoulder pain and increase function. However, there is little data about the neurophysiological effects of these mobilizations.

Objectives: To investigate the initial effects of an anteroposterior (AP) shoulder joint mobilization on measures of pain and function in overhead athletes with chronic shoulder pain.

Detailed Description

Design: Double-blind, controlled, within-subjects repeated-measures design Method: Thirty-one overhead athletes with chronic shoulder pain participated. The effects of a 9-min, AP mobilization of the glenohumeral joint were compared with manual contact and no-contact interventions. Pressure pain threshold (PPT), range of movement (ROM), muscle strength, self-reported pain, and disability were measured immediately before and after each intervention.

Study Timeline

• Study First Submitted: 2018-01-11
• Study First Submitted QC: 2018-01-29
• Study First Posted: 2018-01-31
• Study Start: 2018-02-15
• Status Verified: 2018-03
• Primary Completion: 2018-03-15
• Study Completion: 2018-03-15
• Last Update Submitted: 2018-03-25
• Last Update Posted: 2018-03-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 31

Inclusion Criteria

• History of chronic shoulder pain lasting ≥3 months.
• Play overhead sport regularly.

Exclusion Criteria

• Had a non-musculoskeletal origin of shoulder pain.
• Previous surgery to the shoulder complex.
• Frozen shoulder.
• Any co-existing inflammatory, infectious or neurological condition.
• The patient from physiotherapy treatment.
• Any evidence of pain referred from the cervical spine to the shoulder

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
The manual contact condition	The manual contact condition	In this condition the therapist positioned the patient in a mid-range position of glenohumeral abduction and internal rotation and applied the hands to the same contact point as in the treatment condition.
Mobilization to the glenohumeral joint	Mobilization to the glenohumeral joint	This condition consisted on the application of a passive rhythmic AP mobilization to the glenohumeral joint of the affected shoulder
The manual contact condition	No-contact condition	In this condition the therapist positioned the patient in a mid-range position of glenohumeral abduction and internal rotation and applied the hands to the same contact point as in the treatment condition.

Primary Outcome Measures

Name	Time	Method
Self-reported shoulder pain	Change from Baseline at 5 minutes after intervention	Participants were asked to indicate the intensity of their current shoulder pain using a numeric rating pain scale (NRPS). In this scale, 0 is not pain and 10 is the worse pain possible

Secondary Outcome Measures

Name	Time	Method
Shoulder disability	Change from Baseline at 24 hours after treatment	The DASH is comprised of 30 items (disability/symptom section) and two optional sections related to the impact of pathology on work and sports. Each item is scored from 1 to 5 with increasing values representing more severity of symptoms. The total score for the disability/symptoms section ranges from 30 to 150, but it is then transformed to a scale from 0 (better score possible) to 100 (worse score possible).
Shoulder range of movement (ROM)	Change from Baseline at and 5 minutes after treatment	Active elevation in the scapular plane and passive glenohumeral internal and external rotation were measured using a Standard BASELINE ® 12-inch plastic goniometer following previous guidelines. The 0 degrees of movement is worse and 180 degrees is the better
Shoulder muscles strength	Change from Baseline at 5 minutes after treatment	Isometric strength of the shoulder internal and external rotator musculature was measured using a portable hand-held dynamometer (Nicholas Manual Muscle Tester, Lafayette Instruments, USA). Normal external rotation strength is 20 Newtons and 27 newton in internal rotation strength
Pressure pain threshold (PPT)	Change from Baseline at 5 minutes after treatment	The PPT was measured using an analogue Fisher algometer (Force Dial model FDK, Wagner Instruments) with a surface area at the round tip of 1cm2. The algometer probe tip was applied perpendicular to the skin at a rate of 1kg/cm2/s until the first onset of pain. The PPT value is specific in each subject.The minimal clinically important difference is 2Kg/cm

Trial Locations

Locations (1)

Clinical University; 🇪🇸 Alcala de Henares, Madrid, Spain