Combined Effects of Manual Therapy on the Shoulder

Not Applicable

Completed

• Conditions: Range of Motion; Manual Therapies; Shoulder Joint Disorder
• Interventions: Other: Sleeper stretch; Other: posterior glide mobilization; Other: thoracic manipulation

• Registration Number: NCT04777370
• Lead Sponsor: University of Hartford

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.

Detailed Description

Forty individuals with a loss of internal rotation (IR) ROM will be recruited and randomized to one of two interventions at the first session: either posterior glenohumeral mobilization or internal rotation "sleeper" stretching. At the second visit, all participants will undergo a thoracic manipulation (T3-4 segment) followed by a repeat of either the sleeper stretch or glenohumeral mobilization.

Study Timeline

• Study First Submitted: 2021-02-22
• Study First Submitted QC: 2021-02-25
• Study First Posted: 2021-03-02
• Study Start: 2021-03-31
• Primary Completion: 2021-06-30
• Study Completion: 2021-06-30
• Status Verified: 2021-07
• Last Update Submitted: 2021-07-06
• Last Update Posted: 2021-07-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

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

Exclusion Criteria

• 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,
• any history of coagulation disorders.
• Individuals with a history of shoulder surgery will reviewed on a case by case basis.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
sleeper stretch + thoracic manipulation	Sleeper stretch	The group will receive the sleeper stretch at session #1, and a thoracic manipulation followed by the sleeper stretch at session #2.
sleeper stretch + thoracic manipulation	thoracic manipulation	The group will receive the sleeper stretch at session #1, and a thoracic manipulation followed by the sleeper stretch at session #2.
posterior glenohumeral (PG) mobilization + thoracic manipulation	posterior glide mobilization	The group will receive a posterior glide mobilization at session #1, and a thoracic manipulation followed by posterior glide mobilization at session #2.
posterior glenohumeral (PG) mobilization + thoracic manipulation	thoracic manipulation	The group will receive a posterior glide mobilization at session #1, and a thoracic manipulation followed by posterior glide mobilization at session #2.

Primary Outcome Measures

Name	Time	Method
Change in infraspinatus electromyographic activity (%MVIC)	Pre intervention to immediate (within 5 minutes) post intervention	activity of the infraspinatus muscle during posterior translation, assessed as a percentage of the maximal voluntary isometric contraction (MVIC)
Change in shoulder IR ROM	Pre intervention to immediate (within 5 minutes) post intervention	Shoulder IR ROM measured with a goniometer
Change in posterior shoulder translation (mm)	Pre intervention to immediate (within 5 minutes) post intervention	maximum posterior translation of the humeral head assessed with ultrasound imaging (mm)

Trial Locations

Locations (1)

University of Hartford; 🇺🇸 West Hartford, Connecticut, United States