In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .
Cervicothoracic Manual Therapy Plus Exercise Therapy Versus Exercise Therapy Alone in the Management of Individuals With Shoulder Pain: A Multicenter Randomized Controlled Trial.
Study Design Multicenter r and omized controlled trial . Background Cervicothoracic manual therapy has been shown to improve pain and disability in individuals with shoulder pain , but the incremental effects of manual therapy in addition to exercise therapy have not been investigated in a r and omized controlled trial . Objectives To compare the effects of cervicothoracic manual therapy and exercise therapy to those of exercise therapy alone in individuals with shoulder pain . Methods Individuals ( n = 140 ) with shoulder pain were r and omly assigned to receive 2 sessions of cervicothoracic range-of-motion exercises plus 6 sessions of exercise therapy , or 2 sessions of high-dose cervicothoracic manual therapy and range-of-motion exercises plus 6 sessions of exercise therapy ( manual therapy plus exercise ) .  Pain and disability were assessed at baseline , 1 week , 4 weeks , and 6 months . The primary aim ( treatment group by time ) was examined using linear mixed-model analyses and the repeated measure of time for the Shoulder Pain and Disability Index ( SPADI ) , the numeric pain-rating scale , and the shortened version of the Disabilities of the Arm , Shoulder and H and question naire ( QuickDASH ) . Patient-perceived success was assessed and analyzed using the global rating of change ( GROC ) and the Patient Acceptable Symptom State ( PASS ) , using chi-square tests of independence . Results There were no significant 2-way interactions of group by time or main effects by group for pain or disability . Both groups improved significantly on the SPADI , numeric pain-rating scale , and QuickDASH . Secondary outcomes of success on the GROC and PASS significantly favored the manual therapy-plus-exercise group at 4 weeks ( P = .03 and P<.01 , respectively ) and on the GROC at 6 months ( P = .04 ) . Conclusion Adding 2 sessions of high-dose cervicothoracic manual therapy to an exercise program did not improve pain or disability in patients with shoulder pain , but did improve patient-perceived success at 4 weeks and 6 months and acceptability of symptoms at 4 weeks . More research is needed on the use of cervicothoracic manual therapy for treating shoulder pain . Level of Evidence Therapy , level 1b . Prospect ively registered March 30 , 2012 at www . Clinical Trials.gov ( NCT01571674 ) . J Orthop Sports Phys Ther 2016;46(8):617 - 628 . doi:10.2519/jospt.2016.6319
In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .