Article

OBJECTIVE: To investigate the short-term effects of thoracic spine manipulation
(TSM) on pain, function, scapular kinematics, and scapular muscle activity in
individuals with shoulder impingement syndrome.
DESIGN: Randomized controlled
trial with blinded assessor and patient. SETTING: Laboratory. PARTICIPANTS:
Patients with shoulder impingement syndrome (N=61). INTERVENTIONS: Participants
were randomly allocated to TSM group (n=30) or sham-TSM group (n=31) and attended
2 intervention sessions over a 1-week period. MAIN OUTCOME MEASURES: Scapular
kinematics and muscle activity were measured at day 1 (baseline, before the first
intervention), day 2 preintervention (before second intervention), day 2
postintervention (after the second intervention), and day 3 (follow-up). Shoulder
pain and function were assessed by the Disability of the Arm, Shoulder and Hand
questionnaire and Western Ontario Rotator Cuff Index at baseline, day 2
preintervention, and follow-up. An assessor blinded to group assignment measured
all outcomes. RESULTS: Pain decreased by 0.7 points (95% confidence interval,
1.3-0.1 points) at day 2 preintervention and 0.9 points (95% confidence interval,
1.5-0.3 points) at day 2 postintervention in the TSM group. The Disability of the
Arm, Shoulder and Hand questionnaire (P=.01) and Western Ontario Rotator Cuff
Index (P=.02) scores improved in both groups. Scapular upward rotation increased
during arm lowering (P<.01) at day 2 postintervention (5.3 degrees ) and
follow-up (3.5 degrees ) in the TSM group. Upper trapezius activity increased
(P<.05) in the sham-TSM group. Middle trapezius, lower trapezius, and serratus
anterior decreased activities in both groups during elevation and lowering of the
arm. CONCLUSIONS: TSM may increase scapular upward rotation during arm lowering.
TSM does not seem to influence activity of the scapular muscles. The results
concerning shoulder pain, function, scapular tilt, and internal rotation are not
conclusive.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS