| Summary: | M.Tech. === PURPOSE: Impingement syndrome of the shoulder is a very common problem, yet the diagnosis and management of it is still not completely understood. The purpose of this pilot study was to determine the most effective chiropractic treatment protocol in the management of impingement syndrome due to supraspinatus tendonitis. This was done by comparing objective and subjective measures gained during a treatment protocol consisting either of administering corrective chiropractic manipulative therapy to the cervical spine and/or the thoracic spine, to the glenohumeral joint or to both of these areas. METHODS: This randomised controlled trial consisted of three groups of fifteen patients, each between the ages of eighteen and forty-five years old. All potential candidates were examined and cleared for participation in the clinical trials subsequent to a selection process and X-ray examination if necessary. Diversified chiropractic manipulative techniques were used for all patients provided joint restrictions were detected. Group A received glenohumeral joint manipulations, Group B received spinal manipulations and Group C received a combination of spinal and glenohumeral joint manipulations. PROCEDURE: Patients were treated for six consultations over a two-week period. A follow-up appointment was scheduled for four weeks after that in order to determine the lasting effects of the treatment protocol. At the first, third, sixth and follow-up visit, measurements were recorded. Objective data included pain free shoulder abduction range of motion, the presence of a painful arc of the shoulder and the presence of a positive supraspinatus test. Subjective data included the numerical pain rating scale-101 scores. RESULTS: statistical analysis was conducted using the parametric One Way ANOVA (analysis of variance) and unpaired t-tests as well as the non-parametric Kruskal-Wallis One Way ANOVA on Ranks and Mann-Whitney Rank Sum tests to compare intragroup and intergroup data. III CONCLUSIONS: Although all three groups showed numerical improvements throughout the treatment period, only group A showed statistically significant improvements. This study therefore suggests that manipulation of the glenohumeral joint is more effective in the treatment of impingement syndrome of the shoulder with regard to short-term as well as long-term symptomatic relief. This however requires further research, as a larger sample size is required
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