Subacute Effects of Spinal Mobilization to Treat Subacromial Impingement

Study Overview
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Brief Summary
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Specific Aims and Hypotheses Aims To investigate the incremental benefits of cervicothoracic spinal manipulation in addition to shoulder mobilization and exercise for improving range of motion, pain, physical function and fear avoidance beliefs in patients with subacromial shoulder impingement. Hypotheses It is hypothesized that those subjects who receive spinal manipulation in addition to shoulder mobilization and exercise will achieve greater improvements in range of motion, pain, function and fear avoidance beliefs at two weeks following treatment conclusion, at 4 weeks following treatment conclusion, and at discharge when compared to the subjects who did not receive the spinal manipulation.

Official Title
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Subacute Effects of Cervicothoracic Spinal Manipulation in Addition to Shoulder Manual Therapy Plus Exercise Intervention in Individuals With Subacromial Impingement Syndrome: a Randomized, Controlled Clinical Trial Pilot Study

Conditions
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Subacromial Impingement Syndrome

Intervention / Treatment
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* Other: thoracic mobilization & shoulder mobilization & exercise
* Other: shoulder mobilization & exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: To be eligible, participants must meet the clinical prediction rule for unilateral subacromial shoulder impingement including: a) positive Hawkins-Kennedy impingement sign, b) positive painful arc sign, and c) weakness in external rotation with the arm at the side Exclusion Criteria: Individuals with contraindications to treatment with mobilization and manipulation (Appendix A) will be excluded

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 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: Thoracic Mobilization<br>thoracic mobilization in addition to shoulder mobilization plus exercise | Other: thoracic mobilization & shoulder mobilization & exercise<br> <br> Other: shoulder mobilization & exercise<br> <br> |
| Active Comparator: exercise only<br>shoulder mobilization plus exercise alone | Other: shoulder mobilization & exercise<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Shoulder Pain and Disability Index Change over time | Patients will be followed for the duration of their physical therapy treatment. An average of 12 visits over 6 weeks | 2 weeks, 4 weeks, discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric Pain Rating Scale change over time | Patients will be followed for the duration of their physical therapy treatment. An average of 12 visits over 6 weeks | 2 weeks, 4 weeks, discharge | 
| Fear Avoidance Beliefs Questionnaire change over time | Patients will be followed for the duration of their physical therapy treatment. An average of 12 visits over 6 weeks | 2 weeks, 4 weeks, discharge |