Short-Term Effects of Thoracic Spine Manipulation on Shoulder Impingement Syndrome

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 P 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.