Evidence for increased neuromuscular drive following spinal manipulation in individuals with subacromial pain syndrome

Hegarty, Amy K.; Hsu, Melody; Roy, Jean‐Sébastien; Kardouni, Joseph R.; Kutch, Jason J.; Michener, Lori A.

doi:10.1016/j.clinbiomech.2021.105485

Cited by 3 publications

(2 citation statements)

References 49 publications

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“…From the current study, it is not entirely clear which muscles or mechanisms were responsible for limiting the IR PROM gains post thoracic manipulation. Previous work has demonstrated an increase in distal muscular activity following manipulation, 36,53,58 and it is possible that thoracic manipulation had an excitatory effect on the middle deltoid 58,59 or other shoulder musculature. For example, Hawkes et al observed an increase in teres minor and latissimus dorsi activation in concert with deltoid contraction in individuals with rotator cuff pathology, proposed to be a means to decrease humeral head translation.…”

Section: Discussionmentioning

confidence: 99%

Combined Effects of Glenohumeral Mobilization, Stretching, and Thoracic Manipulation on Shoulder Internal Rotation Range of Motion

Swanson,

Hagenbruch,

Lapaan

et al. 2024

International Journal of Sports Physical Therapy

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Background/purpose Interventions including posterior glenohumeral mobilizations (PGM), sleeper stretches, and thoracic manipulation are commonly used to address posterior shoulder tightness. The purpose of this study was to assess the effects of adding thoracic manipulation to PGM and sleeper stretches on passive range of motion (PROM), joint mobility, and infraspinatus electromyographic (EMG) activity in shoulders with decreased internal rotation (IR) PROM. Design Randomized Sequential Intervention Laboratory Study Methods Forty individuals with clinically significant IR loss attended two study sessions. Participants were randomized to receive five 30 seconds bouts of either grade III PGM or sleeper stretching. Following a seven-day washout period, all participants attended a second session and received a prescriptive supine HVLA manipulation targeting the T3-4 segment, followed by the previously randomized intervention. Outcome measures included internal rotation PROM, horizontal adduction PROM, posterior glenohumeral joint translation assessed via ultrasound imaging, and EMG activity of the infraspinatus during a PGM. All outcome measures were assessed pre- and immediately post-intervention and compared statistically. Results There were significant within-group, but not between-group, differences for IR and horizontal adduction PROM following a single session of PGM or sleeper stretch. When combined with thoracic manipulation, significantly smaller within session changes of IR PROM were observed for both PGM (mean difference 4.4, p=0.017) and sleeper stretches (mean difference 6.4, p=0.0005). There were no significant between group differences for horizontal adduction PROM, humeral head translation, or EMG activity across all time points. Discussion Both GH posterior mobilizations and sleeper stretches improved IR and horizontal adduction PROM in a single session. The addition of thoracic manipulation prior to local shoulder interventions resulted in smaller gains of both IR and horizontal adduction ROM. Level of evidence Level 2

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Section: Discussionmentioning

confidence: 99%

Combined Effects of Glenohumeral Mobilization, Stretching, and Thoracic Manipulation on Shoulder Internal Rotation Range of Motion

Swanson,

Hagenbruch,

Lapaan

et al. 2024

International Journal of Sports Physical Therapy

View full text Add to dashboard Cite

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“…Joint stiffness, one of the commonly cited reasons for acute pain, can get promptly relieved by re-establishing normal joint motion [27]. The swift, controlled thrusts might play a role in breaking adhesions or restoring the joint's natural movement, which could be the reason behind the immediate reduction in pain intensity post-treatment [28,29].The neurophysiological mechanism of thrust manipulation is conclusively explained by spinal cord mechanisms. Pain due to peripheral sensitization is caused by temporal summation of C-fibers, and it has been reported that thrust manipulation can interrupt this summation [30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Immediate or Short-term Effects of Thrust Manipulation on Acute to Subacute Low Back Pain: A Systematic Review and Meta-Analysis

Lee,

Kim

2023

Phys Ther Rehabil Sci

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Objective: Clinical practice guidelines for chronic low back pain (LBP) strongly recommend thrust manipulation; however, its effectiveness for acute and subacute nonspecific LBP is controversial. Therefore, the aim of this systematic review and meta-analysis was to synthesize the immediate or short-term effects of thrust manipulation on pain in patients with acute and subacute LBP. Design: Asystematic review and meta-analysis. Methods: A literature search was performed in international databases (CINAHL, Embase, MEDLINE, PubMed) in June 2023. Search terms were set according to PICOSD (participants, intervention, comparison, outcomes, study design). Risk of bias (RoB) assessment was performed using the RoB tool and quantitative analysis was performed using RevMan 5.4. The effect measure was standard mean difference (SMD) and the analysis model was random effect model. Results: The database was searched for 249 studies and six randomized controlled trials (RCTs) were finally synthesized after independent review by researchers. Only pain intensity was found to have a significant effect on pain intensity and disability (p<0.05). The pooled results showed a small effect size for pain intensity in acute to subacute LBP with thrust manipulation in sixRCTs(SMD= -0.44; 95% CI, -0.80 to -0.08) and a large effect size for disability in three RCTs (SMD= -0.96; 95% CI, -2.67 to 0.76). Conclusions: In conclusion, this review provides evidence supporting the effectiveness of thrust manipulation in reducing pain intensity and disability in patients with acute and subacute LBP. It highlights the potential benefits of incorporating thrust manipulation as a treatment option for LBP.

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Effect of adding thoracic manipulation for the management of patients with adhesive capsulitis: a randomized clinical trial

El Melhat,

Abbas,

Zebdawi

et al. 2024

Physiotherapy Theory and Practice

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Evidence for increased neuromuscular drive following spinal manipulation in individuals with subacromial pain syndrome

Cited by 3 publications

References 49 publications

Combined Effects of Glenohumeral Mobilization, Stretching, and Thoracic Manipulation on Shoulder Internal Rotation Range of Motion

Combined Effects of Glenohumeral Mobilization, Stretching, and Thoracic Manipulation on Shoulder Internal Rotation Range of Motion

Immediate or Short-term Effects of Thrust Manipulation on Acute to Subacute Low Back Pain: A Systematic Review and Meta-Analysis

Effect of adding thoracic manipulation for the management of patients with adhesive capsulitis: a randomized clinical trial

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