A Comparison of the Effects of Cervical and Thoracic Manipulation, Glenohumeral Mobilization, and Sleeper Stretch on Shoulder Strength and Range of Motion in Healthy Individuals
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 48
- 试验地点
- 2
- 主要终点
- Change in shoulder ER strength
研究概览
简要总结
The purpose of this study is to directly compare the effects of four distinct interventions commonly used in the treatment of shoulder pathology on shoulder range of motion (ROM) and strength in asymptomatic shoulders:
- grade III oscillatory anterior-posterior glenohumeral joint mobilizations
- an internal rotation (IR) "sleeper" stretch
- supine upper-thoracic manipulation
- cervical spine manipulation
详细描述
Research questions:
Do different interventions result in different immediate changes in shoulder ROM? Ha1: Stretching and glenohumeral mobilization will result in increased shoulder ROM Ha2: Thoracic and Cervical manipulations will result in decreased shoulder ROM Ho: There will be no differences in shoulder ROM between groups for each of the four interventions
Do different interventions result in different immediate effects for shoulder external rotation (ER) strength? Ha1: Stretching and glenohumeral mobilization will result in a decrease in ER strength Ha2: Thoracic and cervical manipulations will result in increased ER strength Ho: There will be no differences in ER strength between groups for each of the four interventions
Do different interventions result in different immediate effects for shoulder electromyographic (EMG) activity? Ha1: Stretching and glenohumeral mobilization will result in a decrease in EMG activity Ha2: Thoracic and cervical manipulations will result in increased EMG activity Ho: There will be no differences EMG activity between groups for each of the four interventions
Based on pilot data, the apparent effect sizes ranged from .57 - .78. With the ɑ = .05 and 1-β = .80, G-power software for a 4 group ANOVA yields a sample of 20 participants per group. To account for possible sample variations and participant drop-outs, a sample of 24 per group will be enrolled. Based on the study design of a randomized cross-over study, where each participant will receive two of the interventions, a total sample of 48 individuals will be enrolled.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
outcomes assessor blinded to group allocations
入排标准
- 年龄范围
- 18 Years 至 55 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Participants will be included in this study if they:
- •are between the ages of 18 and 55
- •have no history of shoulder, neck, or upper back dysfunction.
排除标准
- •Individuals will be excluded if they report having any of the following conditions:
- •shoulder, neck, or upper back pain;
- •prior shoulder, neck or upper back surgery;
- •previous injury to shoulder, neck, or thoracic area;
- •active inflammatory disease process in treatment area;
- •osteoporosis;
- •signs and symptoms of a nerve root pathology/radiculopathy (dermatomal sensory changes, myotomal weakness, reflex changes);
- •upper motor neuron lesions/spinal cord pathology;
- •local infection;
- •active or history of cancer;
- •long term corticosteroid use;
- •systemically unwell;
- •systemic hyperlaxity;
- •known connective tissue disease;
- •known abnormalities of the spine;
- •disturbance of bowel or bladder;
- •coronary artery disease;
- •unstable upper cervical spine;
- •positive testing for vertebral basilar insufficiency (VBI);
- •spondylolisthesis;
- •spondylosis;
- •pregnancy or recent pregnancy;
- •nervous system dysfunction;
- •has received physical therapy for related shoulder, neck, or upper thoracic dysfunction;
- •blood clotting disorder;
- •receiving workman's compensation or involved in an active lawsuit;
- •currently taking fluoroquinolones (Cipro, Factive, Levaquin, Avelox, Noroxin, Floxin)
- •any other known contraindication to manual therapy The study will not include adults unable to consent/persons with cognitive/developmental disability, individuals who are not yet adults, pregnant women, or prisoners or other detained individuals.
结局指标
主要结局
Change in shoulder ER strength
时间窗: immediate pre-post intervention
pre-test post-test strength test of the infraspinatus with hand held dynamometer
change in infraspinatus EMG activity
时间窗: immediate pre-post intervention
change in pre-post test EMG peak and mean root squared activity
Change in shoulder IR ROM
时间窗: immediate pre-post intervention
change pre-post test IR ROM at 90 degrees ABD
change in posterior shoulder mobility
时间窗: immediate pre-post intervention
change in pre-post test posterior shoulder mobility assessed in horizontal adduction
次要结局
未报告次要终点