The Immediate Effects of a Seated Versus Supine Upper Thoracic Spine Thrust Manipulation Compared to Sham Manipulation in Individuals With Subacromial Pain Syndrome: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 60
- 主要终点
- Change in Penn Shoulder Score (PSS) from baseline to 48 hours
研究概览
简要总结
This study evaluates the immediate and short-term effects of a supine upper thoracic spine thrust manipulation, seated upper thoracic spine thrust manipulation, and sham manipulation for individuals with subacromial pain syndrome. The participants were randomized to receive one of the three interventions and baseline measures for the dependent variables were repeated immediately after the delivery of the intervention.
详细描述
Thoracic spine thrust manipulation has been shown to be effective in reducing pain and improving function in individuals with subacromial pain syndrome (subacromial impingement). It remains unknown if individuals respond differently to different manipulation techniques. This study examines the immediate effects on pain and short-term effects on pain and function using the Penn Shoulder Score (PSS) as well as the immediate effects on scapular kinematics (upward rotation and posterior tilt, specifically), pectoralis minor muscle length, and scapulothoracic muscle force production for the middle trapezius, lower trapezius, and serratus anterior.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
盲法说明
participants were made aware of the 3 different interventions being investigated but were not told which technique they were assigned to receive
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •currently experiencing shoulder pain for less than 6 months
- •at least 3 of the following findings: 1) pain localized to the proximal anterolateral shoulder region, 2) positive Neer or Hawkins-Kennedy impingement test, 3) pain with active shoulder elevation (which may include a painful arc), 4) active shoulder abduction ROM of at least 90°, 5) passive shoulder external rotation ROM of at least 45°, and 6) pain with isometric resisted abduction or external rotation
排除标准
- •signs of a complete rotator cuff tear
- •significant loss of glenohumeral motion
- •acute inflammation
- •cervical spine-related symptoms including a primary complaint of neck pain, signs of central nervous system or cervical nerve root involvement, or reproduction of shoulder or arm pain with cervical rotation, axial compression, or Spurling test
- •previous neck or shoulder surgery
- •positive apprehension test or relocation test
- •history of shoulder fracture or dislocation
- •history of nerve injury affecting upper extremity function
- •any contraindication for thrust manipulation to the thoracic spine including osteoporosis, fracture, malignancy, systemic arthritis, or infection
- •fear or unwillingness to undergo thoracic spine manipulation
研究组 & 干预措施
Supine thrust manipulation
The supine upper thoracic spine thrust manipulation will be performed two times, regardless of joint cavitation.
干预措施: Supine upper thoracic spine thrust manipulation (Procedure)
Seated thrust manipulation
The seated upper thoracic spine thrust manipulation will be performed two times, regardless of joint cavitation.
干预措施: Seated upper thoracic spine thrust manipulation (Procedure)
Sham manipulation
The sham manipulation will be performed two times.
干预措施: Sham manipulation (Procedure)
结局指标
主要结局
Change in Penn Shoulder Score (PSS) from baseline to 48 hours
时间窗: baseline and 48 hours after intervention
The Penn Shoulder Score is a 100-point shoulder-specific questionnaire with three subscales: self-reported pain, function, and satisfaction with current use of the shoulder. The scores from the subscales are summed to determine the total score with the pain subscale score ranging from 0-30, function subscale score ranging from 0-60, and satisfaction subscale score ranging from 0-10. The total maximum score of 100 points indicates high function, low pain, and high satisfaction with the shoulder.
Change in pain
时间窗: baseline and 1 minute after intervention
Pain will be measured using the verbal numeric rating scale (VNRS). Participants will be asked to rate their pain on a 0-10 scale with 0 indicating no pain and 10 indicating the worst pain imaginable. This pain rating will be obtained during active elevation of the arm in the scapular plane.
次要结局
- Change in scapular upward rotation passive ROM(baseline and 1 minute after intervention)
- Change in pectoralis minor muscle length(baseline and 1 minute after intervention)
- Change in lower trapezius force production(baseline and 1 minute after intervention)
- Change in serratus anterior force production(baseline and 1 minute after intervention)
- Change in scapular upward rotation active range of motion (ROM)(baseline and 1 minute after intervention)
- Change in scapular posterior tilt passive ROM(baseline and 1 minute after intervention)
- Change in scapular posterior tilt active ROM(baseline and 1 minute after intervention)
- Change in middle trapezius force production(baseline and 1 minute after intervention)
研究者
Jason Grimes, PT, PhD, OCS, ATC
Clinical Assistant Professor
Sacred Heart University