Effects of Thoracic Mobilization on Shoulder Range of Motion

Study Overview
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Brief Summary
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The purpose of this study is to investigate the effect of thoracic spine joint manipulation versus a sham intervention on active and passive shoulder flexion (elevation), external rotation, and internal rotation range of motion.

Detailed Description
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Many individuals who have a primary complaint of shoulder pain often demonstrate deficits in glenohumeral and scapulothoracic mobility. Typically individuals will have limitations in shoulder range of motion, specifically, flexion (elevation) as well as external and internal rotation. Although the glenohumeral joint is the primary joint for shoulder motion adjacent joints such as the sternoclavicular, acromioclavicular, scapulothoracic, and thoracic spine also contribute to maximal shoulder motion. Limited shoulder motion may be a result of joint hypomobility, muscle inhibition, or pain. Typically interventions such as stretching and joint mobilization/manipulation are directed at the glenohumeral joint to improve shoulder motion, but little is known about interventions targeting adjacent sites which may also improve shoulder range of motion. This study will evaluate the effect of thoracic spine joint manipulation on active and passive shoulder range of motion.

Official Title
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Effects of Thoracic Mobilization on Shoulder Range of Motion

Conditions
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Shoulder Range of Motion in Healthy Individuals

Intervention / Treatment
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* Other: Thoracic Mobilization
* Other: Sham


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults 19-45 years Exclusion Criteria: Individuals who are pregnant History of cervical or thoracic surgery Bone or joint disease Current infection or tumor Osteopenia/osteoporosis Spinal fracture Rheumatologic pathologies

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Thoracic Mobilization<br>The subject will be in a prone position and the physical therapist will first identify the upper thoracic spine region. The physical therapist will then cross his or her hands and place them on opposite sides of the spinous processes using the pisiforms as the contact area. The subject will be asked to exhale and upon exhalation the physical therapist will apply a small amplitude, quick thrust at end of range. | Other: Thoracic Mobilization<br>* The subject will be in a prone position and the physical therapist will first identify the upper thoracic spine region. The physical therapist will then cross his or her hands and place them on opposite sides of the spinous processes using the pisiforms as the contact area. The subject will be asked to exhale and upon exhalation the physical therapist will apply a small amplitude, quick thrust at end of range.<br>* Other names: small amplitude, quick thrust mobilization/manipulation;|
| Sham Comparator: Sham<br>The subject will be in a prone position and the physical therapist will first identify the upper thoracic spine region. The physical therapist will then cross his or her hands and place them on opposite sides of the spinous processes using the pisiforms as the contact area. The subject will be asked to exhale and upon exhalation the physical therapist will not apply any other force than light hand contact. | Other: Sham<br>* The subject will be in a prone position and the physical therapist will first identify the upper thoracic spine region. The physical therapist will then cross his or her hands and place them on opposite sides of the spinous processes using the pisiforms as the contact area. The subject will be asked to exhale and upon exhalation the physical therapist will not apply any other force than light hand contact.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Shoulder Range of motion | To determine changes in shoulder active and passive range of motion following one of two intervention protocols. Changes will be measured by examining shoulder range of motion in three directions: Shoulder flexion, internal rotation and external rotation. We hypothesize that the use of a thoracic spine joint manipulation will increase shoulder range of motion in flexion (elevation) as well as external and internal rotation to a greater degree than a sham mobilization. | Single Study Visit | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Thoracic, Manipulation, Manual Therapy, Mobilization, Shoulder, Range of Motion