Does thoracic manipulation increase shoulder range of movement in patients with subacromial impingement syndrome? A pilot study

Abstract

Aim

This pilot study was designed to assess the effect of thoracic manipulation on shoulder range and function in patients with subacromial impingement syndrome (SIS).

Methods

Patients attending a National Health Service physiotherapy department with SIS were considered for inclusion. Participants were randomized into one of two groups. Both groups received weekly physiotherapy for a maximum of 6 weeks. In addition, the experimental group received thoracic spinal manipulation. Outcome measures were shoulder range and function measured by a goniometer and the Disability of the Arm, Shoulder and Hand Score, respectively.

Results

Nine participants were recruited; eight completed the study. Both groups improved, but numbers were inadequate for statistically significant conclusions.

Conclusions

This pilot study confirms the practicality of the study design used: a longer recruitment period and multicentre involvement is recommended together with a cost–benefit analysis.

Keywords:

• Subacromial impingement
• Shoulder
• Thoracic spine
• Posture
• Manipulation
• Physiotherapy

Acknowledgements

The author thanks Dr John Foster, Middlesex University for statistical advice, Meg Gilbert, Clinical Supervisor, Society of Orthopaedic Medicine and physiotherapy colleagues from Aneurin Bevan Health Board. The research was conducted as part of the principal author's MSc Orthopaedic Medicine.