Combined Effects of Manual Therapy on the Shoulder

Range of Motion Clinical Trial

Official title:

Are There Differences in Range of Motion, Glenohumeral Translation, and Rotator Cuff Activity Following Shoulder Mobilization, Stretching, or Thoracic Manipulation?

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04777370
• Other study ID #: PRO2021000105
• Status: Completed
• Phase: N/A
• Start date: March 31, 2021
• Est. completion date: June 30, 2021

Study information

• Verified date: July 2021
• Source: University of Hartford
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 40
• Est. completion date: June 30, 2021
• Est. primary completion date: June 30, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 60 Years

Eligibility

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.

Related Conditions & MeSH terms

• Joint Diseases
• Manual Therapies
• Range of Motion
• Shoulder Joint Disorder

Intervention

Other:
• 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.
• 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.
• 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.

Locations

Country	Name	City	State
United States	University of Hartford	West Hartford	Connecticut

Sponsors (1)

Lead Sponsor	Collaborator
University of Hartford

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in shoulder IR ROM	Shoulder IR ROM measured with a goniometer	Pre intervention to immediate (within 5 minutes) post intervention
Primary	Change in posterior shoulder translation (mm)	maximum posterior translation of the humeral head assessed with ultrasound imaging (mm)	Pre intervention to immediate (within 5 minutes) post intervention
Primary	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)	Pre intervention to immediate (within 5 minutes) post intervention