Shoulder Pain
Conditions
Keywords
Manual Therapy, Physical Therapy, First Rib, Joint Mobilization, Shoulder Pain
Brief summary
The purpose of this clinical trial is to examine whether one session of a specific manual physical therapy technique, known as first rib mobilization, can lead to immediate improvements in pain and movement in individuals with shoulder pain. We hypothesize that this single treatment will result in reduced pain and increased ability to move the shoulder and neck. Researchers will compare first rib mobilization to a sham mobilization (a look-alike hands-on position that does not mobilize the first rib) to see if first rib mobilization works to immediately reduce pain and improve movement in patients with shoulder pain. Participants will receive first rib mobilization or a sham mobilization during a single session of physical therapy and will receive pre and post intervention measurements of their pain levels and neck and shoulder range of motion.
Interventions
Participants in the mobilization group will receive either a seated or supine three stage progressive muscle energy technique (MET) plus a singular high-velocity, low-amplitude thrust (HVLAT) mobilization technique directed to their first rib on their symptomatic side based on the discretion of the treating physical therapist.
OTHERSham Comparator
Participants in the sham mobilization (control) group will be placed in a supine, hook-lying position identical to the mobilization group; however, they will be instructed to inhale and exhale 3 times using diaphragmatic breathing (avoiding upper chest recruitment) as the physical therapist gently rests his or her hand over the area of the upper trapezius muscle just proximal to the first rib to simulate a sham mobilization hand placement. Therefore, physical therapists will not use any significant compressive force to the musculature, perform any tactile cueing for upper chest breathing, perform any mobilizations, nor perform any HVLAT techniques to participants in the sham mobilization group.
Sponsors
Lebanon Valley College
Andrews University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Men and Women * Ages 18-75 years old * Attending physical therapy * Primary complaint of shoulder pain * Pain intensity \>3/10 on the Numeric Pain Rating Scale (NPRS) * A Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick DASH) score greater than 16% impaired
Exclusion criteria
* Previous shoulder or neck surgery * Clinical signs of a full rotator cuff tear (positive drop arm test) * Having positive MRI findings of a complete rotator cuff tear * Having a positive Spurling's test * Having a steroid injection in the cervical spine and/or shoulder in the last two months * Having any red flags (history of cancer, upper motor neuron disorder, fractures, osteoporosis, acute inflammatory process) * Expressing fear/anxiety related to receiving manual therapy treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Range of motion | Cervical and shoulder active range of motion will be assessed in participants in both groups at baseline and immediately following the intervention | Cervical and Shoulder active range of motion |
| Pain Intensity | Change in pain intensity from baseline to immediately following intervention in both groups | Pain Intensity will be assessed via the Numeric Pain Rating Scale (NPRS). On this scale, zero is equivalent to no pain and 10 indicates the worst possible pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Global Rating of Change | This will be administered to participants in both groups immediately after intervention | The GROC is a single-item measure that captures a patient's perceived change in their condition over time. It uses a 15-point scale ranging from -7 (a very great deal worse) to +7 (a very great deal better), with 0 indicating no change. |
Countries
United States
Contacts
Primary ContactJoseph R Hribick, Doctor of Physical Therapy
Backup ContactElizabeth Oakley, Doctor of Health Science
Outcome results
None listed