Shoulder
Conditions
Keywords
Osteopathic Physicians, Shoulder, Diagnostic Imaging, Motion Capture, Range of Motion, Articular, Blood Circulation, Pain
Brief summary
The purpose of this study is to see the impact of a modified Spencer's technique on tissue stiffness, mobility, and blood flow of the shoulder joint. Spencer's technique is a well-known osteopathic manipulative treatment (OMT) that is common for treating adhesive capsulitis and is believed to help blood flow. There are studies that look at the clinical effects of the technique and/or compare it to other techniques; however, measuring the extent to which Spencer's technique, or this modified technique, improves tissue stiffness and blood flow has never been written in the literature. This study will serve as a proof of concept that this technique improves tissue stiffness, blood flow, and mobility of the shoulder join as well as the nearby areas. Using ultrasound, the investigators will measure tissue stiffness and blood flow and will analyze the mobility of the shoulder joint using a Vicon motion capture system.
Interventions
OTHEROsteopathic Manipulative Treatment-Spencer's Technique (Modified)
Combination OMT approach utilizing Muscle Energy Technique (MET), Articulatory Technique (ART), and Myofascial Release (MFR). It is a series of direct OMT addressing the barrier of somatic dysfunction (SD) with the goal of restoring neurovascular balance and improved motion of the shoulder girdle and glenohumeral joint. Utilizing these three OMT techniques, the practitioner attempts restoration of glenohumeral joint motion using shoulder extension, flexion, circumduction with compression, circumduction with distraction, abduction, adduction, external rotation, internal rotation, and distraction in abduction. The study uses a modified version of the Spencer technique, done in the seated position for patient comfort, as well as adding to the treatment sequence: latissimus dorsi, pectoralis minor-major, serratus anterior, and rhomboid major-minor. Adding these muscles into treatment will help to address and correct sternoclavicular joint SD, acromioclavicular joint SD, and scapular SD.
OTHERRest
10 minute rest period.
Sponsors
Edward Via Virginia College of Osteopathic Medicine
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Two by Two cross-over trial. Measurements will be taken on both shoulders with only the dominant shoulder receiving osteopathic manipulative treatment (OMT). The order in which the measurements and OMT treatment is performed will be randomized. The cross-over design allows for the opportunity to estimate 3 components, the possible effect of ultrasound measurement on the outcomes even when OMT is not performed, the combined effect of OMT and ultrasound measurements on outcomes, and an adjusted estimate OMT treatment effect removing any ultrasound effects if those effects exist. Change scores for all outcomes will be calculated per shoulder and then a comparison between change scores will be conducted using a paired design.
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
• male and female subjects 18-50 years old
Exclusion criteria
* prior shoulder surgery or injury to the reported dominant throwing arm * shoulder pain in the reported dominant throwing arm within the last 6 months * diagnosis cervical radiculopathy or pinched nerve in the neck * connective tissue or muscle disorders * known pregnancy * tobacco use * known diabetes or prediabetes * allergy to ultrasound gel (propylene glycol)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Stiffness | Day 1 Pre, Day 1 Post, Day 2 | Using Shear Wave Elastography to measure muscle stiffness (kPa) of the supraspinatus, infraspinatus, posterior shoulder capsule, and coracoacromial ligament. |
| Shoulder Mobility | Day 1 Pre, Day 1 Post, Day 2 | Using Vicon motion capture system to calculate landmark coordinates and using morphometric canonical variate analysis to analyze mobility changes. |
| Microvascular/capillary blood flow | Day 1 Pre, Day 1 Post, Day 2 | Using ultrasound to capture blood flow of the supraspinatus, infraspinatus, posterior shoulder capsule, and coracoacromial ligament. |
| Subjective Shoulder Stiffness (Visual Analogue Scale) | Day 1 Pre, Day 2 | Using Visual Analogue scale to measure participant's subjective measure of shoulder stiffness. Scores range from 0 to 10, with 0 being "Not stiff at all" and 10 being "Very stiff." |
Countries
United States
Outcome results
None listed