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OpenTrials
Completed

NCT Number: NCT04777370

Combined Effects of Manual Therapy on the Shoulder

Interventions including glenohumeral mobilization, sleeper stretches, and thoracic manipulation have been proposed for individuals with loss of shoulder range of motion (ROM). However, the effect of these interventions on shoulder ROM, joint translation, and muscular activity have not been studied in combination.

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Key information

Conditions

Range of Motion Manual Therapies Shoulder Joint Disorder

Age range

18 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Hartford

West Hartford, Connecticut, 06117, United States

About this study

Forty individuals with a loss of internal rotation (IR) ROM will be recruited and randomized to one of two interventions at the first session: either posterior glenohumeral mobilization or internal rotation "sleeper" stretching. At the second visit, all participants will undergo a thoracic manipulation (T3-4 segment) followed by a repeat of either the sleeper stretch or glenohumeral mobilization.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • loss of IR of 15 degrees of greater compared to contralateral shoulder

Exclusion criteria

  • currently neck/upper back pain,
  • history of spinal fractures,
  • numbness/altered sensation of the arms or legs,
  • whiplash injury within the prior 6 weeks,
  • infections of the spine,
  • currently pregnant/possibly pregnant,
  • known osteoporosis,
  • Rheumatoid arthritis,
  • previous spine surgery,
  • currently receiving Workman's Compensation,
  • any pending litigation regarding a neck or shoulder injury,
  • history of oral corticosteroids in the prior 6 months,
  • history of shoulder fractures,
  • Current treatment for cancer,
  • Prior history of cancer involving the spine/shoulder,
  • any history of coagulation disorders.
  • Individuals with a history of shoulder surgery will reviewed on a case by case basis.

Treatment and study plan

posterior glide mobilization

Other

The participant will be positioned supine on a plinth, with their scapula stabilized against a firm wedge on the table, and the shoulder joint in the resting position (approx. 55 degrees abduction, 30 degrees horizontal adduction, and slight external rotation). With the extremity held in the same position, the researcher will then apply a grade III (into tissue stretch) PG mobilization. This will consist of five 30-second bouts of sustained gr III posterior glide mobilizations.

Sleeper Stretch

Other

All participants randomized to the stretching group will perform five 30-second holds of the sleeper stretch. This is performed by lying on the side to be stretched, elevating the upper arm to 90° on the support surface with the elbow bent 90°, then passively internally rotating the shoulder with force provided by with the opposite arm.

Thoracic manipulation

Other

Individuals will then undergo a single supine grade V thrust manipulation. All manipulations will take place at the T3-4 segment. If a cavitation ("pop") is not heard or felt by either the subject or examiner, a second thrust will be performed.

Primary outcomes

  1. Change in shoulder IR ROM

    Time frame: Pre intervention to immediate (within 5 minutes) post intervention

    Shoulder IR ROM measured with a goniometer

  2. Change in posterior shoulder translation (mm)

    Time frame: Pre intervention to immediate (within 5 minutes) post intervention

    maximum posterior translation of the humeral head assessed with ultrasound imaging (mm)

  3. Change in infraspinatus electromyographic activity (%MVIC)

    Time frame: Pre intervention to immediate (within 5 minutes) post intervention

    activity of the infraspinatus muscle during posterior translation, assessed as a percentage of the maximal voluntary isometric contraction (MVIC)

Sponsors and collaborators

Lead sponsor

University of Hartford

Other

Registry information

Official study title

Are There Differences in Range of Motion, Glenohumeral Translation, and Rotator Cuff Activity Following Shoulder Mobilization, Stretching, or Thoracic Manipulation?

Important dates

Study start
2021
Primary completion
2021
Study completion
2021
First posted
Mar 2, 2021
Registry last updated
Jul 7, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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