Effectiveness of Thoracic Spine Manipulation on Subjects with Subacromial Impingement Syndrome

Abstract

Background: Subacromial impingement syndrome is one of the most debilitating conditions affecting the shoulder joint and principal cause of shoulder pain. Though the role of manual physical therapy of thoracic spine along with the other treatment options at shoulder joint is well established, the specific effects of manual physical therapy techniques are not adequately reported. Objective: This study was primarily designed to investigate the effectiveness of high velocity low amplitude thrust manipulation of thoracic spine on the subjects with the subacromial impingement syndrome. Methodology: This study was quasi experimental trail in which 30 patients were recruited using a convenience sampling technique, for a single treatment session of high velocity low amplitude thrust manipulation at thoracic spine. Immediate effects of this intervention were recorded on 100mm Visual Analogue Scale and improvement in ROM at shoulder joint as primary outcome measure. A14 points patient reported Global Rating of Change scale was also used as secondary outcome measure. Results: There was mean reduction of pain by 27.03 ± 12.92 (p-value < 0.05) which was statistically and clinically significant. There was also improvement in shoulder range of motion by 25°- 35° and mean post treatment global rating of change score of 4.03 with median score of 5. Conclusion: Thoracic spine manipulative technique is effective in terms of reducing subjective pain and improving range of motion at shoulder joint in subjects with subacromial impingement syndrome. This also signifies the potential interdependence between anatomical regions of thoracic spine and shoulder girdle. KeyWords: Shoulder Pain, Manipulation, Manual Therapy, Subacromial Impingement Syndrome.