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 .
Efficacy of Hand Behind Back Mobilization With Movement for Acute Shoulder Pain and Movement Impairment: A Randomized Controlled Trial.
OBJECTIVE The aim of this study was to investigate the effects of h and -behind-back ( HBB ) Mulligan mobilization with movement ( MWM ) techniques on acute shoulder pain , impairment , and disability . METHODS This double-blind , r and omized , controlled trial recruited 44 patients with acute shoulder pain and movement impairment presenting to an Indian general hospital . Participants were allocated to receive either MWM and exercise/hot pack ( n = 22 ) or exercise/hot pack alone ( n = 22 ) . The average duration of symptoms was 4.1 and 4.7 weeks in the exercise and MWM groups , respectively . The primary outcome was HBB range of motion ( ROM ) . Secondary variables were shoulder internal rotation ROM , pain intensity score , and shoulder disability identified by the shoulder pain and disability index . All variables were evaluated by a blinded assessor before and immediately after 9 treatment sessions over 3 weeks . RESULTS Paired t tests revealed that both groups demonstrated statistically significant improvements ( P < .001 ) with large effect sizes for all variables . However , for all variables , the MWM-with-exercise group showed significantly greater improvements ( P < .05 ) than the exercise group . H and -behind-back ROM showed a mean difference of 9.31 ° ( 95 % confidence interval , 7.38 - 11.27 ) , favoring greater improvement in the MWM-with-exercise group . CONCLUSIONS In this study , the outcomes of patients with acute shoulder pain and disability receiving  shoulder HBB MWM with exercise improved greater than those receiving exercise/hot packs alone
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 .