Clinical trial NCT02083796: Short-term Effects of Thoracic Manipulation in Shoulder Impingement
Official title: Short-term Effects of Thoracic Manipulation on Scapular Kinematics, Muscle Activity and Pain in Shoulder Impingement. A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Shoulder Impingement Syndrome
Keywords: manual therapy
rehabilitation
shoulder
spine
Lead sponsor: Universidade Federal de Sao Carlos
Sponsor class: OTHER
Collaborators: name: Fundação de Amparo à Pesquisa do Estado de São Paulo
First posted: 2014-03-11
Enrollment: 110
Sex: ALL
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The hypothesis of this study is that thoracic spine manipulation would reduce pain in subjects with SIS and cause changes in scapular kinematics and muscle activity in subjects with impingement symptoms and in asymptomatic subjects. With this study, the investigators want to answer if possible changes in scapular motion and muscle activity following a TSM depend on the symptoms or if it is generic to individuals without shoulder dysfunction and not specific to subjects with shoulder impingement.

Detailed description: Subjects with shoulder impingement signs will be evaluated and will be compared with subjects asymptomatic for shoulder symptoms. Both subjects will be randomly assigned to one of two intervention groups: thoracic spinal manipulation (TSM) or sham intervention. We want to know if possible changes in scapular motion and muscle activity following a TSM depend on the symptoms or if it is generic to everyone. Also, we want to know if TSM reduces shoulder pain immediately and in a short-therm period.

Eligibility criteria: Inclusion Criteria (symptomatic subjects): To present with at least 3 of the following findings:

* positive Neer impingement test,
* positive Hawkins impingement test,
* positive Jobe test,
* pain with passive or isometric resisted shoulder lateral rotation,
* pain with active shoulder elevation,
* pain with palpation of rotator cuff tendons,
* pain in the C5 or C6 dermatome region.

Exclusion Criteria (symptomatic subjects):

* signs of "red flags" for spinal manipulation (eg, fracture, osteoporosis, malignancy, infection, and active inflammatory process),
* pregnancy
* systemic illnesses
* if received physical therapy or manual therapy treatment within the 6 months prior to the evaluation
* signs of complete rotator cuff tear or acute inflammation
* cervical-thoracic spine related symptoms (ie, positive cervical compression test and excessive kyphosis)
* scoliosis
* glenohumeral instability (ie, positive apprehension, anterior drawer, or sulcus tests)
* previous upper extremity fracture or shoulder surgery.

Exclusion Criteria (asymptomatic subjects):

* any positive test for shoulder impingement
* signs of "red flags" for spinal manipulation (eg, fracture, osteoporosis, malignancy, infection, and active inflammatory process),
* pregnancy
* systemic illnesses
* if received physical therapy or manual therapy treatment within the 6 months prior to the evaluation
* signs of complete rotator cuff tear or acute inflammation
* cervical-thoracic spine related symptoms (ie, positive cervical compression test and excessive kyphosis)
* scoliosis
* glenohumeral instability (ie, positive apprehension, anterior drawer, or sulcus tests)
* previous upper extremity fracture or shoulder surgery.

Primary outcomes:
measure: Change in scapular orientation from first to third day
timeFrame: Day 1; day 2; day 3
Secondary outcomes:
measure: Change in shoulder function from first to third day
timeFrame: Day 1; Day 2; Day 3
measure: Change in scapular muscle activity from first to third day
timeFrame: Day 1; Day 2; Day 3
measure: Change in shoulder pain from first to third day
timeFrame: Day 1; Day 2; Day 3
Other outcomes:
Locations:
city: São Carlos
country: Brazil
facility: Universidade Federal de São Carlos
state: São Paulo
Study officials:
affiliation: Universidade Federal de Sao Carlos
name: Paula R Camargo, doctor
role: STUDY_DIRECTOR
References:
citation: Haik MN, Alburquerque-Sendin F, Camargo PR. Short-Term Effects of Thoracic Spine Manipulation on Shoulder Impingement Syndrome: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2017 Aug;98(8):1594-1605. doi: 10.1016/j.apmr.2017.02.003. Epub 2017 Mar 1.