• Jason K Grimes, Emilio J Puentedura, M Samuel Cheng, and Amee L Seitz.
• J Orthop Sports Phys Ther. 2019 Oct 1; 49 (10): 716-724.

BackgroundSubacromial pain syndrome (SPS) accounts for as much as 44% of shoulder pain encountered by physical therapists. Thoracic spine thrust manipulation (TSTM) is effective in the short term for improving pain and function in individuals with SPS, but its mechanisms remain elusive. Furthermore, it is unknown whether individuals with SPS respond differently based on the TSTM technique received.ObjectivesTo compare the immediate effects of a supine TSTM, seated TSTM, and sham manipulation on the primary outcomes of self-reported pain, function, and satisfaction and secondary biomechanical impairments examined in individuals with SPS.MethodsParticipants in this randomized clinical trial were randomized to receive a seated TSTM (n = 20), supine TSTM (n = 20), or sham manipulation (n = 20). The primary outcomes of self-reported pain, function, and satisfaction were measured via the Penn Shoulder Score. Secondary outcomes were changes in scapular upward rotation and posterior tilt; peak force generated in tests for the middle trapezius, lower trapezius, and serratus anterior; and pectoralis minor muscle length. Impairment measures were immediately reassessed, and the Penn Shoulder Score was reassessed after 48 hours.ResultsThere were no significant between-group differences in immediate or short-term follow-up outcomes.ConclusionTwo TSTM techniques resulted in no differences in pain, satisfaction, and function when compared to a sham manipulation. Thoracic spine thrust manipulation did not have an immediate effect on the scapular impairments examined.Level Of EvidenceTherapy, level 1. J Orthop Sports Phys Ther 2019;49(10):716-724. Epub 12 Mar 2019. doi:10.2519/jospt.2019.8484.

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