Cervicothoracic manual therapy with exercise therapy versus exercise therapy for shoulder pain

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Cervicothoracic manual therapy with exercise therapy versus exercise therapy for shoulder pain

For the people suffering from shoulder pain, cervicothoracic manual therapy has been shown to deal with pain and disability. But, the incremental effects of manual therapy plus exercise therapy have not been investigated in a randomized controlled trial. Thus, a study was performed to distinguish the effects of cervicothoracic manual therapy and exercise to those of exercise therapy alone in individuals with shoulder pain.

Total 140 individuals with shoulder pain were randomly designated to receive 2 sessions of cervicothoracic range-of-motion exercises plus 6 sessions of exercise therapy, or 2 sessions of high-dose cervicothoracic manual therapy and range-of-motion exercises plus 6 sessions of exercise therapy. At baseline, 1 week, 4 weeks, and 6 months, the pain and disability was analyzed. The primary goal was investigated via linear mixed-model analyses and the repeated measure of time for the Shoulder Pain and Disability Index (SPADI), numeric pain-rating scale, and shortened version of Disabilities of Arm, Shoulder and Hand questionnaire (QuickDASH). Chi-square tests of independence was used to attain the Patient Acceptable Symptom State (PASS) and global rating of change (GROC) was used to acquire the patient-perceived success.

Both groups improved remarkably on SPADI, numeric pain-rating scale, and QuickDASH. Secondary results of success on the GROC and PASS significantly promoted manual therapy-plus-exercise group at 4 weeks (P = .03 and P<.01, respectively) and on GROC at 6 months (P = .04).

Improvement in patient-perceived success at 4 weeks and 6 months and acceptability of symptoms at 4 weeks was observed after adding two sessions of high-dose cervicothoracic manual therapy to an exercise program. But, it did not improve pain or disability in patients with shoulder pain. Additional research is required on the use of cervicothoracic manual therapy for treating shoulder pain.

Journal of Orthopaedic & Sports Physical Therapy
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