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 .
Thoracic spinal manipulation for musculoskeletal shoulder pain: Can an instructional set change patient expectation and outcome?
STUDY DESIGN Planned secondary analysis of a r and omized clinical trial . OBJECTIVES To examine : 1 ) patients ' baseline expectations for treatment outcome of thoracic high velocity low amplitude thrust manipulations ( HVLATM ) to the thoracic spine for shoulder pain ; 2 ) if the message conveyed by the clinician changed the patients ' expectation ; 3 ) any differences in outcome based on expectation independent of messaging . ; and 4 ) any differences in outcome for those patients whose expectations significantly changed as a result of the messaging . BACKGROUND Thoracic HVLATM may be an effective intervention for patients suffering from musculoskeletal shoulder pain . The role of expectation in the treatment effectiveness of this intervention has not been established . METHODS Subjects ' expectations regarding the effectiveness of  HVLATM  on shoulder pain were recorded at baseline . This was reassessed immediately following the provision of positive or neutral instructional set . The subjects then received a thoracic or scapular HVLATM . The Shoulder Pain and Disability Index ( SPADI ) and the numeric pain rating scale ( NPRS ) were used as outcomes measures . RESULTS There was a 10 subject change ( 23 % ) in positive expectation that was statistically significant ( p = 0.019 ) following a positive message . There was no statistically significant difference in pain and function when these subjects were compared to all other subjects . CONCLUSION Although patients ' expectations of positive outcome significantly changed when providing a positive instructional set , these changes did not translate into clinical ly significant short term changes in shoulder pain and function . LEVEL OF EVIDENCE 1b
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 .