Immediate Effects of a Seated versus Supine Upper Thoracic Spine Thrust Manipulation Compared to Sham Manipulation in Individuals with Subacromial Pain Syndrome – A Randomized Clinical Trial

Background: Individuals with Subacromial Pain Syndrome (SPS) often present with a variety of contributing factors. It is possible that a subgroup exists within SPS that has primary impairments of scapular mobility and/or muscle strength. In an attempt to better identify scapular contributions in SPS...

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Main Author: Grimes, Jason Keith
Format: Others
Published: NSUWorks 2017
Subjects:
Online Access:https://nsuworks.nova.edu/hpd_pt_stuetd/58
https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=1057&context=hpd_pt_stuetd
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spelling ndltd-nova.edu-oai-nsuworks.nova.edu-hpd_pt_stuetd-10572019-10-20T04:14:14Z Immediate Effects of a Seated versus Supine Upper Thoracic Spine Thrust Manipulation Compared to Sham Manipulation in Individuals with Subacromial Pain Syndrome – A Randomized Clinical Trial Grimes, Jason Keith Background: Individuals with Subacromial Pain Syndrome (SPS) often present with a variety of contributing factors. It is possible that a subgroup exists within SPS that has primary impairments of scapular mobility and/or muscle strength. In an attempt to better identify scapular contributions in SPS, the Scapular Assistance Test (SAT) and Scapula Reposition Test (SRT) have been described. Additionally, thoracic spine thrust manipulation has been shown to be effective for shoulder pain. Problem Statement: It is currently unknown whether or not there are impairments in scapulothoracic muscle force generation or scapular mobility in individuals with SPS who have positive results on the SAT and SRT. It also remains unknown whether individuals with SPS respond differently in the immediate effects on scapular motion, scapulothoracic muscle force generation, pain, or function following different manipulation techniques. Methodology: Sixty subjects with shoulder pain were enrolled in the study. Baseline measures were obtained for scapular upward rotation and posterior tilt, scapulothoracic muscle force generation, pectoralis minor muscle length, pain, and function. Participants were randomized to receive a seated thrust manipulation, supine thrust manipulation, or sham manipulation. Measures were reassessed immediately after treatment and the Penn Shoulder Score (PSS) was reassessed at 48 hours. Results: The results indicated no significant differences in scapular upward rotation or posterior tilt, or muscle force generation based on the results of the SAT or SRT. There was a small but significant difference in pectoralis minor muscle length based on the result of the SAT. There were no significant between-group differences in scapular motion, muscle force generation, or pectoralis minor muscle length based on the treatment received. There were no significant differences in 48-hour improvement in pain, function, satisfaction, and total PSS scores. Small but significant within group changes existed on several measures. Discussion: The SAT and SRT may be ineffective in differentiating scapular movement associated impairments. Thoracic spine thrust manipulation resulted in no greater immediate improvements in scapular motion, strength, pectoralis minor muscle length, pain, or function compared to a sham treatment. The improvements in pain and function are likely not biomechanical in nature and are likely not derived from the manipulative thrust. 2017-01-01T08:00:00Z dissertation application/pdf https://nsuworks.nova.edu/hpd_pt_stuetd/58 https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=1057&context=hpd_pt_stuetd Department of Physical Therapy Student Theses, Dissertations and Capstones NSUWorks Health and environmental sciences Impingement Manual therapy Scapula Shoulder Thoracic spine Thrust manipulation Physical Therapy
collection NDLTD
format Others
sources NDLTD
topic Health and environmental sciences
Impingement
Manual therapy
Scapula
Shoulder
Thoracic spine
Thrust manipulation
Physical Therapy
spellingShingle Health and environmental sciences
Impingement
Manual therapy
Scapula
Shoulder
Thoracic spine
Thrust manipulation
Physical Therapy
Grimes, Jason Keith
Immediate Effects of a Seated versus Supine Upper Thoracic Spine Thrust Manipulation Compared to Sham Manipulation in Individuals with Subacromial Pain Syndrome – A Randomized Clinical Trial
description Background: Individuals with Subacromial Pain Syndrome (SPS) often present with a variety of contributing factors. It is possible that a subgroup exists within SPS that has primary impairments of scapular mobility and/or muscle strength. In an attempt to better identify scapular contributions in SPS, the Scapular Assistance Test (SAT) and Scapula Reposition Test (SRT) have been described. Additionally, thoracic spine thrust manipulation has been shown to be effective for shoulder pain. Problem Statement: It is currently unknown whether or not there are impairments in scapulothoracic muscle force generation or scapular mobility in individuals with SPS who have positive results on the SAT and SRT. It also remains unknown whether individuals with SPS respond differently in the immediate effects on scapular motion, scapulothoracic muscle force generation, pain, or function following different manipulation techniques. Methodology: Sixty subjects with shoulder pain were enrolled in the study. Baseline measures were obtained for scapular upward rotation and posterior tilt, scapulothoracic muscle force generation, pectoralis minor muscle length, pain, and function. Participants were randomized to receive a seated thrust manipulation, supine thrust manipulation, or sham manipulation. Measures were reassessed immediately after treatment and the Penn Shoulder Score (PSS) was reassessed at 48 hours. Results: The results indicated no significant differences in scapular upward rotation or posterior tilt, or muscle force generation based on the results of the SAT or SRT. There was a small but significant difference in pectoralis minor muscle length based on the result of the SAT. There were no significant between-group differences in scapular motion, muscle force generation, or pectoralis minor muscle length based on the treatment received. There were no significant differences in 48-hour improvement in pain, function, satisfaction, and total PSS scores. Small but significant within group changes existed on several measures. Discussion: The SAT and SRT may be ineffective in differentiating scapular movement associated impairments. Thoracic spine thrust manipulation resulted in no greater immediate improvements in scapular motion, strength, pectoralis minor muscle length, pain, or function compared to a sham treatment. The improvements in pain and function are likely not biomechanical in nature and are likely not derived from the manipulative thrust.
author Grimes, Jason Keith
author_facet Grimes, Jason Keith
author_sort Grimes, Jason Keith
title Immediate Effects of a Seated versus Supine Upper Thoracic Spine Thrust Manipulation Compared to Sham Manipulation in Individuals with Subacromial Pain Syndrome – A Randomized Clinical Trial
title_short Immediate Effects of a Seated versus Supine Upper Thoracic Spine Thrust Manipulation Compared to Sham Manipulation in Individuals with Subacromial Pain Syndrome – A Randomized Clinical Trial
title_full Immediate Effects of a Seated versus Supine Upper Thoracic Spine Thrust Manipulation Compared to Sham Manipulation in Individuals with Subacromial Pain Syndrome – A Randomized Clinical Trial
title_fullStr Immediate Effects of a Seated versus Supine Upper Thoracic Spine Thrust Manipulation Compared to Sham Manipulation in Individuals with Subacromial Pain Syndrome – A Randomized Clinical Trial
title_full_unstemmed Immediate Effects of a Seated versus Supine Upper Thoracic Spine Thrust Manipulation Compared to Sham Manipulation in Individuals with Subacromial Pain Syndrome – A Randomized Clinical Trial
title_sort immediate effects of a seated versus supine upper thoracic spine thrust manipulation compared to sham manipulation in individuals with subacromial pain syndrome – a randomized clinical trial
publisher NSUWorks
publishDate 2017
url https://nsuworks.nova.edu/hpd_pt_stuetd/58
https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=1057&context=hpd_pt_stuetd
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