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 .
Validation of a sham comparator for thoracic spinal manipulation in patients with shoulder pain.
The evidence to guide use of spinal manipulative therapy ( SMT ) for patients with shoulder pain is limited . A vali date d sham comparator is needed to ascertain the unique effects of SMT . We investigated the plausibility of a thoracic sham-SMT comparator for SMT in patients with shoulder pain . Participants ( n = 56 ) with subacromial impingement syndrome were r and omized to thoracic SMT or a sham-SMT .  An examiner blinded to group assignment took measures pre- and post-treatment of shoulder active range of motion ( AROM ) and perceived effects of the assigned intervention . Treatment consisted of six upper , middle and lower thoracic SMT or sham-SMT . The sham-SMT was identical to the SMT , except no thrust was applied . Believability as an active treatment was measured post-treatment . Believability as an active treatment was not different between groups ( χ(2 ) = 2.19 ; p = 0.15 ) . Perceptions of effects were not different between groups at pre-treatment ( t = 0.12 ; p = 0.90 ) or post-treatment ( t = 0.40 ; p = 0.69 ) , and demonstrated equivalency with 95 % confidence between groups at pre- and post-treatment . There was no significant change in shoulder flexion in either group over time , or in the sham-SMT for internal rotation ( p > 0.05 ) . The SMT group had an increase of 6.49 ° in internal rotation over time ( p = 0.04 ) . The thoracic sham-SMT of this study is a plausible comparator for SMT in patients with shoulder pain . The sham-SMT was believable as an active treatment , perceived as having equal beneficial effects both when verbally described and after familiarization with the treatment , and has an inert effect on shoulder AROM . This comparator can be considered for used in clinical trials investigating thoracic SMT . IRB number : HM 13182
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 .