Short-Term Effects of Thoracic Manipulation on Lower Trapezius Muscle Strength

Cleland, Joshua A.; Selleck, Ben; Stowell, T. E. A.; Browne, Lindsey; Alberini, Steve; Cyr, Heather St.; Caron, Thomas

doi:10.1179/106698104790825284

Cited by 69 publications

(49 citation statements)

References 20 publications

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“…TSM improved upward rotation by approximately 2.2°, which exceeded the MCID, whereas improvement with the sham intervention was 1.0°. Considering that the lower trapezius is an important upward rotator, 51 these findings are consistent with findings of Cleland et al, 10 who showed that TSM applied to the lower thoracic segments (T6-T12) improved lower trapezius strength in asymptomatic subjects. Furthermore, spinal manipulation [ research report ] seems to alter central sensory processing 15,53 and to improve motor control.…”

Section: Discussionsupporting

confidence: 81%

“…8,46,59 Two studies have evaluated the effects of TSM on the shoulder in asymptomatic individuals compared to a sham group. 10,55 Rosa et al 55 found no changes in scapulohumeral rhythm and scapular kinematics postintervention, whereas Cleland et al 10 demonstrated improvement of lower trapezius muscle strength following TSM. The reason why TSM may produce effects in other body regions is not fully understood.…”

Section: T T Conclusion: Shoulder Pain In Individualsmentioning

confidence: 99%

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Scapular Kinematics Pre– and Post–Thoracic Thrust Manipulation in Individuals With and Without Shoulder Impingement Symptoms: A Randomized Controlled Study

Haik¹,

Alburquerque‐Sendín²,

Silva³

et al. 2014

Journal of Orthopaedic & Sports Physical Therapy

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Shoulder pain is a common and debilitating condi tion, and its prevalence is second only to low back pain. 9,42,52,63 Shoulder im pingement syndrome (SIS) is the most frequently encountered shoulder condition and accounts for 44% to 65% of all shoulder pain. 63 A greater amount of scapular internal rotation, as well as a lesser amount of scapular upward rotation and posterior tilt during arm elevation, has previously been documented in individuals with symptoms of SIS compared to asymptomatic individuals. [35][36][37][38] These kinematic alterations have been associated with lesser activation of the middle and lower trapezius and serratus anterior muscles and excessive upper trapezius muscle activation. 37,51 Systematic literature reviews support the efficacy of therapeutic exercises for the rehabilitation of individuals with SIS, 29,43 and the results of randomized clinical trials suggest that providing manual therapy T T OBJECTIVES:To evaluate the immediate effects of a low-amplitude, high-velocity thrust thoracic spine manipulation (TSM) on pain and scapular kinematics during elevation and lowering of the arm in individuals with shoulder impingement syndrome (SIS). The secondary objective was to evaluate the immediate effects of TSM on scapular kinematics during elevation and lowering of the arm in individuals without symptoms. T T BACKGROUND:Considering the regional interdependence among the shoulder and the thoracic and cervical spines, TSM may improve pain and function in individuals with SIS. Comparing individuals with SIS to those without shoulder pathology may provide information on the effects of TSM specifically in those with SIS. T T METHODS:Fifty subjects (mean  SD age, 31.8  10.9 years) with SIS and 47 subjects (age, 25.8  5.0 years) asymptomatic for shoulder dysfunction were randomly assigned to 1 of 2 interventions: TSM or a sham intervention. Scapular kinematics were analyzed during elevation and lowering of the arm in the sagittal plane, and a numeric pain rating scale was used to assess shoulder pain during arm movement at preintervention and postintervention.

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Section: Discussionsupporting

confidence: 81%

Section: T T Conclusion: Shoulder Pain In Individualsmentioning

confidence: 99%

Scapular Kinematics Pre– and Post–Thoracic Thrust Manipulation in Individuals With and Without Shoulder Impingement Symptoms: A Randomized Controlled Study

Haik¹,

Alburquerque‐Sendín²,

Silva³

et al. 2014

Journal of Orthopaedic & Sports Physical Therapy

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“…87 The researcher's right hand was placed with a flat hand contact under the T4 segment. The patient crossed the arms over the chest, and in this position with minimal mobilization and without manipulation effect, the patient was asked to take a deep inhalation followed by an exhalation at which time a light 3-second compression of the arms into the chest was achieved.…”

mentioning

confidence: 99%

Immediate effects of a thoracic spine thrust manipulation on the autonomic nervous system: a randomized clinical trial

Sillevis¹,

Cleland²,

Hellman³

et al. 2010

Journal of Manual & Manipulative Therapy

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Thoracic spine manipulation has been shown to be effective for the management of neck pain. The purpose of this study was to investigate the immediate effect of a T3-T4 spinal thrust manipulation on autonomic nervous system activity in subjects with chronic cervical pain. An additional aim was to determine if the manipulation resulted in an immediate pain relief in patients with chronic neck pain when compared to a placebo intervention. One hundred subjects with chronic neck pain were randomly assigned to receive either a thoracic thrust manipulation or a placebo intervention. The Friedman's test was used to evaluate the change in pupil diameter within both groups. The Wilcoxen signed-ranks test was used to explore pupil changes over time and to make paired comparisons of the pupil change between the groups. The MannWhitney U test was used to compare the change in pain perception for the chronic cervical pain group subjects receiving either the thrust manipulation or the placebo intervention. The results demonstrated that manipulation did not result in a change in sympathetic activity. Additionally, there was no significant difference in the subject's pain perception (P50.961) when comparing the effects of the thrust manipulation to the placebo intervention within this group of subjects with chronic neck pain. The clinical impression of this study is that manipulation of the thoracic spine may not be effective in immediately reducing pain in patients with chronic neck pain.

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“…14 In addition, pain and dysfunction of the second rib and cervicothoracic junction were identified in 40% of 101 individuals with NSSP, which was not present in age-matched asymptomatic individuals. 15 Theoretically, treatment to the thoracic spine may biomechanically restore the 15u u of thoracic extension required to achieve full shoulder elevation, 16 improve the recruitment of muscles in the shoulder girdle 17,18 or have a neurophysiological effect on pain and dysfunction. 19 The current evidence for TMT in treating shoulder pain includes a narrative review, 20 which was updated in 2013.…”

Section: Introductionmentioning

confidence: 99%

Thoracic manual therapy in the management of non-specific shoulder pain: a systematic review

Peek¹,

Miller²,

Heneghan³

2015

Journal of Manual & Manipulative Therapy

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Objectives: Non-specific shoulder pain (NSSP) is often persistent and disabling leading to high socioeconomic costs. Cervical manipulation has demonstrated improvements in patients with NSSP, although risks associated with thrust techniques are documented. Thoracic manual therapy (TMT) may utilise similar neurophysiological effects with less risk. The current evidence for TMT in treating NSSP is limited to systematic reviews of manual therapy (MT) applied to the upper quadrant. These reviews included trials that used shoulder girdle manual therapy (SG-MT) in the TMT group. This limits the scope of their conclusions with regard to the exclusive effectiveness of TMT for NSSP. Methods: This review used a steering group for subject and methodological expertise and was reported in line with Preferred Reporting items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Key databases were searched (1990-2014) using relevant search terms and medical subject headings (MeSH); eligibility was evaluated independently by two reviewers based on pre-defined criteria. Study participants had NSSP including impingement syndrome and excluding cervical pain. Interventions included cervicothoracic junction and TMT with or without supplementary exercises. Studies that included MT applied to the shoulder girdle including the glenohumeral joint, acromioclavicular joint or sternoclavicular joint in the TMT group, without a control, were excluded. Included studies utilised outcome measures that monitored pain and disability scores. Randomized controlled trials (RCTs) and clinical studies were eligible. Using a standardised form, each reviewer independently extracted data. Risk of bias was assessed using GRADE and PEDro scale. Results were tabulated for semi-quantitative comparison. Results: Over 912 articles were retrieved: three RCTs, one single-arm trial and three pre-post test studies were eligible. Studies varied from poor to high quality. Three RCTs demonstrated that TMT reduced pain and disability at 6, 26 and 52 weeks compared with usual care. Two pre-post test studies found between 76% and 100% of patients experienced significant pain reduction immediately post-TMT. An additional pre-post test study and a single-arm trial showed reductions in pain and disability scores 48 hours post-TMT. Discussion: Thoracic manual therapy accelerated recovery and reduced pain and disability immediately and for up to 52 weeks compared with usual care for NSSP. Further, high-quality RCTs investigating the effect of TMT in isolation for the treatment of patients with NSSP are now required.

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Short-Term Effects of Thoracic Manipulation on Lower Trapezius Muscle Strength

Cited by 69 publications

References 20 publications

Scapular Kinematics Pre– and Post–Thoracic Thrust Manipulation in Individuals With and Without Shoulder Impingement Symptoms: A Randomized Controlled Study

Scapular Kinematics Pre– and Post–Thoracic Thrust Manipulation in Individuals With and Without Shoulder Impingement Symptoms: A Randomized Controlled Study

Immediate effects of a thoracic spine thrust manipulation on the autonomic nervous system: a randomized clinical trial

Thoracic manual therapy in the management of non-specific shoulder pain: a systematic review

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