Combined Effects of Manual Therapy on the Shoulder

NCT ID: NCT04777370

Last Updated: 2021-07-07

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-03-31
• Study Completion Date: 2021-06-30

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.

Conditions

Range of Motion; Manual Therapies; Shoulder Joint Disorder

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: SEQUENTIAL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

sleeper stretch + thoracic manipulation

The group will receive the sleeper stretch at session #1, and a thoracic manipulation followed by the sleeper stretch at session #2.

Group Type: EXPERIMENTAL

Sleeper stretch

Intervention Type: OTHER

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

Intervention Type: OTHER

Individuals will then undergo a single supine grade V thrust manipulation. All manipulations will take place at the T3-4 segment. If a cavitation ("pop") is not heard or felt by either the subject or examiner, a second thrust will be performed.

posterior glenohumeral (PG) mobilization + thoracic manipulation

The group will receive a posterior glide mobilization at session #1, and a thoracic manipulation followed by posterior glide mobilization at session #2.

Group Type: EXPERIMENTAL

posterior glide mobilization

Intervention Type: OTHER

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.

thoracic manipulation

Intervention Type: OTHER

Individuals will then undergo a single supine grade V thrust manipulation. All manipulations will take place at the T3-4 segment. If a cavitation ("pop") is not heard or felt by either the subject or examiner, a second thrust will be performed.

Interventions

posterior glide mobilization

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.

Intervention Type: OTHER

Sleeper stretch

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.

Intervention Type: OTHER

thoracic manipulation

Individuals will then undergo a single supine grade V thrust manipulation. All manipulations will take place at the T3-4 segment. If a cavitation ("pop") is not heard or felt by either the subject or examiner, a second thrust will be performed.

Intervention Type: OTHER

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.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Hartford

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Brian Swanson, PT, DSc

Role: PRINCIPAL_INVESTIGATOR

University of Hartford

Locations

University of Hartford

West Hartford, Connecticut, United States

Countries

United States

Other Identifiers

PRO2021000105

Identifier Type: -

Identifier Source: org_study_id