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Immediate effects of thoracic manipulation on the scapulohumeral rhythm in subjects with shoulder impingement: randomized controlled trial

Grant number: 12/22209-6
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Effective date (Start): April 01, 2013
Effective date (End): December 31, 2013
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Paula Rezende Camargo
Grantee:Caroline Zacariotto Silva
Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil


Shoulder impingement is a common cause of pain and is associated with alterations in scapular kinematics and scapulohumeral rhythm. There is some evidence of the effectiveness of manual therapy and spinal manipulation on shoulder impingement rehabilitation when combined with therapeutic exercises. However, there is no evidence of the effects of spinal manipulation on shoulder kinematics. The objective of the study is to evaluate the immediate effects of thoracic spinal manipulation on scapulohumeral rhythm in healthy subjects and individuals with shoulder impingement during arm flexion. Methods: twenty-five subjects asymptomatic for shoulder dysfunction and twenty-five subjects with shoulder impingement will participate in this study. Three-dimensional shoulder kinematic during arm flexion will be evaluated in all subjects before and after receiving a thoracic manipulation of the middle thoracic spine. Three repetitions will be performed. The scapulohumeral rhythm will be calculated by the ratio of glenohumeral elevation and upward rotation of the scapula every 30° increment of arm elevation (30°-60°, 60°-90°, and 90°-120°) and between 30° and 120° of arm elevation. The WORC questionnaire will also be used to assess pain and shoulder function. Only the affected side of subjects with shoulder impingement will be evaluated while in asymptomatic subjects the side will be randomized. Statistical analysis will depend on the normality of the data evaluated by the Shapiro-Wilk test. A significance level of 5% will be considered. (AU)

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