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 .
The effects of thoracic spine manipulation in subjects with signs of rotator cuff tendinopathy.
STUDY DESIGN Controlled laboratory study . OBJECTIVES To assess scapular kinematics and electromyographic signal amplitude of the shoulder musculature , before and after thoracic spine manipulation ( TSM ) in subjects with rotator cuff tendinopathy ( RCT ) . Changes in range of motion , pain , and function were also assessed . BACKGROUND There are various treatment techniques for RCT . Recent studies suggest that TSM may be a useful component in the management of pain and dysfunction associated with RCT . METHODS Thirty subjects between 18 and 45 years of age , who showed signs of RCT , participated in this study . Changes in scapular kinematics and muscle activity , as well as changes in shoulder pain and function , were assessed pre-TSM and post-TSM using paired t tests and repeated- measures analyses of variance . RESULTS TSM did not lead to changes in range of motion or scapular kinematics , with the exception of a small decrease in scapular upward rotation ( P = .05 ) . The only change in muscle activity was a small but significant increase in middle trapezius activity ( P = .03 ) . After TSM , subjects demonstrated decreased pain during performance of the Jobe empty-can ( mean ± SD change , 2.6 ± 1.1 ) , Neer ( 2.6 ± 1.3 ) , and Hawkins-Kennedy ( 2.8 ± 1.3 ) tests ( all , P<.001 ) . Subjects also reported decreased pain with shoulder flexion ( mean ± SD change , 2.0 ± 1.5 ; P<.001 ) and improved shoulder function ( force production , 2.5 ± 1.4 kg ; Penn Shoulder Score , 7.7 ± 9.4 ; sports/performing arts module of the Disabilities of the Arm , Shoulder and H and question naire , 16.4 ± 13.2 ) ( all , P<.001 ) . CONCLUSION Immediate improvements in shoulder pain and function post-TSM are not likely explained by alterations in scapular kinematics or shoulder muscle activity . For people with pain associated with RCT , TSM may be an effective component of their treatment plan to improve pain and function . However , further r and omized controlled studies are necessary to better vali date this treatment approach . LEVEL OF EVIDENCE Therapy , level 4
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 .