- Title
- Thoracic Manual Therapy Improves Pain and Disability in Individuals With Shoulder Impingement Syndrome Compared With Placebo: A Randomized Controlled Trial With 1-Year Follow-up
- Creator
- Hunter, Donald J.; Rivett, Darren A.; McKiernan, Sharmaine; Luton, Renae; Snodgrass, Suzanne J.
- Relation
- Archives of Physical Medicine and Rehabilitation Vol. 103, Issue 8, p. 1533-1543
- Publisher Link
- http://dx.doi.org/10.1016/j.apmr.2022.03.003
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2022
- Description
- Objective: To investigate whether muscle energy technique (MET) to the thoracic spine decreases the pain and disability associated with shoulder impingement syndrome (SIS). Design: Single-center, 3-arm, randomized controlled trial, single-blind, placebo control with concealed allocation and a 12-month follow-up. Setting: Private osteopathic practice. Participants: Three groups of 25 participants (N=75) 40 years or older with SIS received allocated intervention once a week for 15 minutes, 4 consecutive weeks. Interventions: Participants were randomly allocated to MET to the thoracic spine (MET-only), MET plus soft tissue massage (MET+STM), or placebo. Main Outcome Measures: Primary outcome measure: Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Secondary outcome measures: Shoulder Pain and Disability Index (SPADI) questionnaire; visual analog scale (VAS) (mm/100): current, 7-day average, and 4-week average; Patient-Specific Functional Scale (PSFS); and Global Rating of Change (GROC). Measures recorded at baseline, discharge, 4-week follow-up, 6 months, and 12 months. Also baseline and discharge thoracic posture and range of motion (ROM) measured using an inclinometer. Statistical analysis included mixed-effects linear regression model for DASH, SPADI, VAS, PSFS, GROC, and thoracic posture and ROM. Results: MET-only group demonstrated significantly greater improvement in pain and disability (DASH, SPADI, VAS 7-day average) than placebo at discharge (mean difference, DASH=−8.4; 95% CI, −14.0 to −2.8; SPADI=−14.7; 95% CI, −23.0 to −6.3; VAS=−15.5; 95% CI, −24.5 to −6.5), 6 months (−11.1; 95% CI, −18.6 to −3.7; −14.9; 95% CI, −26.3 to −3.5; −14.1; 95% CI, −26.0 to −2.2), and 12 months (−13.4; 95% CI, −23.9 to−2.9; −19.0; 95% CI, −32.4 to −5.7; −17.3; 95% CI, −30.9 to −3.8). MET+STM group also demonstrated greater improvement in disability but not pain compared with placebo at discharge (DASH=−8.2; 95% CI, −14.0 to −2.3; SPADI=−13.5; 95% CI, −22.3 to −4.8) and 6 months (−9.0; 95% CI, −16.9 to −1.2; −12.4; 95% CI, −24.3 to −0.5). For the PSFS, MET-only group improved compared with placebo at discharge (1.3; 95% CI, 0.1-2.5) and 12 months (1.8; 95% CI, 0.5-3.2); MET+STM at 12 months (1.7; 95% CI, 0.3-3.0). GROC: MET-only group improved compared with placebo at discharge (1.5; 95% CI, 0.9-2.2) and 4 weeks (1.0; 95% CI, 0.1-1.9); MET+STM at discharge (1.2; 95% CI, 0.5-1.9) and 6 months (1.2; 95% CI, 0.1-1.3). There were no differences between MET-only group and MET+STM, and no between-group differences in thoracic posture or ROM. Conclusions: MET of the thoracic spine with or without STM improved the pain and disability in individuals 40 years or older with SIS and may be recommended as a treatment approach for SIS.
- Subject
- pain; rehabilitation; shoulder impingement syndrome; shoulder
- Identifier
- http://hdl.handle.net/1959.13/1485929
- Identifier
- uon:51733
- Identifier
- ISSN:0003-9993
- Language
- eng
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