Clinical trial NCT04777370: Combined Effects of Manual Therapy on the Shoulder
Official title: Are There Differences in Range of Motion, Glenohumeral Translation, and Rotator Cuff Activity Following Shoulder Mobilization, Stretching, or Thoracic Manipulation?
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Range of Motion
Manual Therapies
Shoulder Joint Disorder
Keywords: shoulder
Glenohumeral Internal Rotation Deficit (GIRD)
joint play
muscular activity
Lead sponsor: University of Hartford
Sponsor class: OTHER
First posted: 2021-03-02
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: SEQUENTIAL
Intervention model description: All participants will undergo a single intervention during the first session, and then combined thoracic manipulation and a repeat of the prior intervention at the second session.
Primary purpose: TREATMENT

Brief summary: Interventions including glenohumeral mobilization, sleeper stretches, and thoracic manipulation have been proposed for individuals with loss of shoulder range of motion (ROM). However, the effect of these interventions on shoulder ROM, joint translation, and muscular activity have not been studied in combination.

Detailed description: Forty individuals with a loss of internal rotation (IR) ROM will be recruited and randomized to one of two interventions at the first session: either posterior glenohumeral mobilization or internal rotation "sleeper" stretching. At the second visit, all participants will undergo a thoracic manipulation (T3-4 segment) followed by a repeat of either the sleeper stretch or glenohumeral mobilization.

Eligibility criteria: Inclusion Criteria:

* loss of IR of 15 degrees of greater compared to contralateral shoulder

Exclusion Criteria:

* currently neck/upper back pain,
* history of spinal fractures,
* numbness/altered sensation of the arms or legs,
* whiplash injury within the prior 6 weeks,
* infections of the spine,
* currently pregnant/possibly pregnant,
* known osteoporosis,
* Rheumatoid arthritis,
* previous spine surgery,
* currently receiving Workman's Compensation,
* any pending litigation regarding a neck or shoulder injury,
* history of oral corticosteroids in the prior 6 months,
* history of shoulder fractures,
* Current treatment for cancer,
* Prior history of cancer involving the spine/shoulder,
* any history of coagulation disorders.
* Individuals with a history of shoulder surgery will reviewed on a case by case basis.

Primary outcomes:
measure: Change in shoulder IR ROM
timeFrame: Pre intervention to immediate (within 5 minutes) post intervention
measure: Change in posterior shoulder translation (mm)
timeFrame: Pre intervention to immediate (within 5 minutes) post intervention
measure: Change in infraspinatus electromyographic activity (%MVIC)
timeFrame: Pre intervention to immediate (within 5 minutes) post intervention
Secondary outcomes:
Other outcomes:
Locations:
city: West Hartford
country: United States
facility: University of Hartford
state: Connecticut
Study officials:
affiliation: University of Hartford
name: Brian Swanson, PT, DSc
role: PRINCIPAL_INVESTIGATOR
References: