The Effectiveness of Self-thoracic Spine Mobilization on Improving Sleep Quality in Patients Who Have Shoulder Pain

Study Overview
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Brief Summary
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This project aims to study the impacts of self-thoracic spine and rib mobilization on sleep quality in patients who present to UTSW physicians with shoulder pain. The investigators plan to randomize participants into treatment and control groups, but the investigators will provide education on sleep hygiene for each group. The treatment group will also receive instruction to mobilize their thoracic spine and ribs each night before going to sleep.

Detailed Description
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Subjects with a chief complaint of musculoskeletal pain will be recruited from clinics in the Departments of Internal Medicine, Family Medicine, and Orthopedic Surgery. Subjects will be randomized into either the intervention or control group. The intervention group will receive education on sleep hygiene and instruction to use a foam roller to mobilize the thoracic spine and ribs just before the subject goes to sleep. The control group will receive education on sleep hygiene. Valid and reliable measures will be used to assess sleep quality (Pittsburgh Sleep Quality Index), pain (Numeric Pain Rating Scale), and function (SF-36 and ASES), as well as a sleep diary. Measures will be taken at baseline as well as two weeks after the subject's enrollment in the study.

Official Title
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The Effectiveness of Self-thoracic Spine Mobilization on Improving Sleep Quality in Patients Who Have Shoulder Pain

Conditions
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Shoulder Pain Chronic

Intervention / Treatment
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* Procedure: Self-mobilization
* Procedure: Sleep Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Shoulder pain with associated sleeping disturbance Between the ages of 18-89 Present to the clinics in the Departments of Internal Medicine, Family Medicine, and Orthopedic Surgery at UTSW Exclusion Criteria: non-English speakers chronic pain or rheumatic disorders unstable psychopathology, cognitive impairment (including dementia) current or recent history (within 6 months) of substance abuse disorders recent history of surgery or fracture to the cervical spine, thoracic spine, ribs, or shoulders (within 6 months) metabolic bone disease (including osteoporosis) fusion or ankyloses osteomyelitis, pregnancy, vertebral basilar insufficiency, neoplastic disease, malignancy in the area of treatment actively treated for sleep disorders (including insomnia) uncontrolled congestive heart failure, COPD, hypertension, or other serious medical illness

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 89 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Self-mobilization<br>Use of foam roller to mobilize thoracic spine and ribs every night before going to bed | Procedure: Self-mobilization<br>* Subjects will mobilize thoracic spine and ribs with a foam roller every night before going to bed.<br>|
| Active Comparator: Sleep Education<br>Education on sleep hygiene with tips for improving sleep. | Procedure: Sleep Education<br>* Subjects will be educated on sleep hygiene in order to improve likelihood of having good sleep.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pittsburgh Sleep Index | Valid and reliable 19 item assessment of sleep quality, with higher scores indicating greater sleep disturbance | Baseline, 1 week, and 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric Pain Rating Scale | Valid and reliable 11 point rating of pain, with higher scores indicating more pain | Baseline, 1 week, and 2 weeks | 
| SF-36 | Valid and reliable 36 item assessment of quality of life, with higher scores indicating lower disability | Baseline, 1 week, and 2 weeks |