The purpose of this clinical trial is to examine whether one session of a specific manual physical therapy technique, known as first rib mobilization, can lead to immediate improvements in pain and movement in individuals with shoulder pain. We hypothesize that this single treatment will result in reduced pain and increased ability to move the shoulder and neck. Researchers will compare first rib mobilization to a sham mobilization (a look-alike hands-on position that does not mobilize the first rib) to see if first rib mobilization works to immediately reduce pain and improve movement in patients with shoulder pain. Participants will receive first rib mobilization or a sham mobilization during a single session of physical therapy and will receive pre and post intervention measurements of their pain levels and neck and shoulder range of motion.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
64
Participants in the mobilization group will receive either a seated or supine three stage progressive muscle energy technique (MET) plus a singular high-velocity, low-amplitude thrust (HVLAT) mobilization technique directed to their first rib on their symptomatic side based on the discretion of the treating physical therapist.
Participants in the sham mobilization (control) group will be placed in a supine, hook-lying position identical to the mobilization group; however, they will be instructed to inhale and exhale 3 times using diaphragmatic breathing (avoiding upper chest recruitment) as the physical therapist gently rests his or her hand over the area of the upper trapezius muscle just proximal to the first rib to simulate a sham mobilization hand placement. Therefore, physical therapists will not use any significant compressive force to the musculature, perform any tactile cueing for upper chest breathing, perform any mobilizations, nor perform any HVLAT techniques to participants in the sham mobilization group.
Lebanon Valley College
Annville, Pennsylvania, United States
Range of motion
Cervical and Shoulder active range of motion
Time frame: Cervical and shoulder active range of motion will be assessed in participants in both groups at baseline and immediately following the intervention
Pain Intensity
Pain Intensity will be assessed via the Numeric Pain Rating Scale (NPRS). On this scale, zero is equivalent to no pain and 10 indicates the worst possible pain.
Time frame: Change in pain intensity from baseline to immediately following intervention in both groups
Global Rating of Change
The GROC is a single-item measure that captures a patient's perceived change in their condition over time. It uses a 15-point scale ranging from -7 ("a very great deal worse") to +7 ("a very great deal better"), with 0 indicating "no change."
Time frame: This will be administered to participants in both groups immediately after intervention
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