THE EFFECTS OF THORACIC SPINE MOBILIZATION IN SUBJECTS WITH SIGNS OF
SHOULDER IMPINGEMENT
Muth S,PT, NCS; McClure P, PT, PhD; Barbe M, PhD; Lauer R, Phd
Place of Completion: Arcadia University, Glenside PA,
Presenter Address: 3014 Cambridge St, Philadelphia PA, 19130
Purpose/Hypothesis: The purpose of this investigation was to assess changes in shoulder pain and
function, including force production, following two thoracic spine manipulations in subjects with signs of
shoulder impingement.
Subjects: Thirty subjects between the ages of 18 and 45 with signs of shoulder impingement were
recruited for this study.
Materials/Methods: Electromagnetic sensors tracked three-dimensional motion of the thorax and cervical
spine. Subjects rated their pain on an 11 point numeric pain rating scale (NPRS) during the performance
of three provocative clinical tests (Jobes empty can, Hawkins-Kennedy and Neer’s test for impingement)
and while performing loaded flexion, scaption, and abduction before and after receiving a mid thoracic
spine and cervico-thoracic junction manipulation. Immediate changes in force production were assessed
using a hand-held dynamometer and changes in function and disability were assessed 7 – 10 days after
receiving the treatment with the Penn Shoulder Score (PSS) the Sport/Performing Arts Module of the
Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH).
Results: Subjects demonstrated decreased pain with performance of provocative clinical tests. Mean
changes in pain ratings for each test are as follows: Jobes 2.6 ± 1.2, Neer’s 2.3 ± 1.2, Hawkins-Kennedy
2.8 ± 1.3( p<0.001 for all three tests) as well as with loaded shoulder flexion (2.0 ± 1.5; p<0.001),
scaption (1.2±1.4; p < .001) and abduction (2.2±1.5; p < .001) and cervical rotation (0.4 ± .93; P=0.04).
Force production also improved immediately following thoracic spine manipulation (5.5±3.1; p <0.001).
Improvements in function and decreased disability were also reported on the PSS (7.7 ± 9.3; p< .001) and
Sport/Performing Arts Module of the DASH (16.4 ± 13.2; p<0.001) respectively. No significant changes
in cervical rotation or trunk flexion/extension range of motion were found.
Conclusions: The results of this investigation suggest that thoracic spine manipulation may decrease pain
and improve shoulder function, including force production, in people with signs of shoulder
impingement. These changes were not explained by increased thoracic or cervical ROM.
Clinical Relevance: Thoracic spine manipulation may be a viable treatment option, in conjunction with
other neuromuscular rehabilitative techniques, for the treatment of pain and disability associated with
shoulder impingement.
muthst@umdnj.edu
Poster