Combined Effects of Manual Therapy on the Shoulder

University of Hartford40 enrolled

Overview

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.

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Range of Motion Manual Therapies Shoulder Joint Disorder

Interventions

posterior glide mobilizationOTHER

The participant will be positioned supine on a plinth, with their scapula stabilized against a firm wedge on the table, and the shoulder joint in the resting position (approx. 55 degrees abduction, 30 degrees horizontal adduction, and slight external rotation). With the extremity held in the same position, the researcher will then apply a grade III (into tissue stretch) PG mobilization. This will consist of five 30-second bouts of sustained gr III posterior glide mobilizations.

Sleeper stretchOTHER

All participants randomized to the stretching group will perform five 30-second holds of the sleeper stretch. This is performed by lying on the side to be stretched, elevating the upper arm to 90° on the support surface with the elbow bent 90°, then passively internally rotating the shoulder with force provided by with the opposite arm.

thoracic manipulation

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 Years

Medical Language ↔ Plain English

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.

Locations (1)

University of Hartford

West Hartford, Connecticut, United States

Outcomes

Primary Outcomes

Change in shoulder IR ROM

Shoulder IR ROM measured with a goniometer

Time frame: Pre intervention to immediate (within 5 minutes) post intervention

Change in posterior shoulder translation (mm)

maximum posterior translation of the humeral head assessed with ultrasound imaging (mm)

Time frame: Pre intervention to immediate (within 5 minutes) post intervention

Change in infraspinatus electromyographic activity (%MVIC)

activity of the infraspinatus muscle during posterior translation, assessed as a percentage of the maximal voluntary isometric contraction (MVIC)

Time frame: Pre intervention to immediate (within 5 minutes) post intervention

Data from ClinicalTrials.gov

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