Effect of adding thoracic manipulation for the management of patients with adhesive capsulitis: a randomized clinical trial.

IF 1.6 4区医学 Q2 REHABILITATION

Physiotherapy Theory and Practice Pub Date : 2025-01-01 Epub Date: 2024-02-14 DOI:10.1080/09593985.2024.2316897

Ahmed M El Melhat, Rami L Abbas, Moustafa R Zebdawi, Ali Mohamed Ali Ismail

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引用次数: 0

Abstract

Background: Research is supporting thoracic spine manipulation (TSM) as an intervention in treating adhesive capsulitis (AC) when coupled with physical therapy interventions.

Purpose: To investigate whether TSM improves AC outcomes when combined with physical therapy interventions.

Method: A double-blinded, randomized, controlled trial with 40 patients assigned into two groups. The experimental group (EG) received physical therapy intervention and TSM; the control group (CG) had physical therapy with sham manipulation. Both groups received interventions biweekly for 12 weeks. Outcomes included Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), scapular upward rotation, and shoulder passive range of motion conducted at baseline, after 1 session, 6 and 12 weeks.

Results: Both groups improved significantly after 6 and 12 weeks in pain, disability (p = 0.01 for both; d = 1.53 and 1.46, respectively), scapular upward rotation, shoulder flexion (p = 0.02 for both; d = 2.2 and 0.92, respectively), abduction (p = 0.04; d = 0.07), and external rotation (p = 0.03; d = 0.7). However, CG showed no significant improvement in pain or disability after one session (p = 0.14 and p = 0.16, respectively; d = 0.46 for both). Between groups, results favored EG significantly in pain, disability, scapular upward rotation, shoulder flexion, and abduction (p = 0.02, p = 0.01, p = 0.02, p = 0.05, and p = 0.04, respectively) at 6 weeks (d = 0.81, d = 0.87, d = 0.67, d = 0.64, and d = 0.69, respectively).

Conclusion: The results suggest that adding TSM yielded superior clinical benefits when compared to physical therapy interventions in AC patients. Nevertheless, it is imperative to acknowledge a specific limitation in our study is the omission of passive internal rotation assessment. This aspect represents a notable constraint in our research.

Clinical trial registry number: Pan African clinical trial registry "PACTR202303495421928".

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增加胸椎手法治疗粘连性关节囊炎患者的效果：随机临床试验。

背景：目的：研究胸椎手法（TSM）与物理治疗干预相结合是否能改善粘连性关节囊炎（AC）的治疗效果：一项双盲、随机对照试验将 40 名患者分为两组。实验组（EG）接受物理治疗干预和 TSM；对照组（CG）接受物理治疗和假手法。两组均每两周接受一次干预，为期 12 周。结果包括基线、1 次治疗后、6 周和 12 周的视觉模拟量表 (VAS)、肩部疼痛和残疾指数 (SPADI)、肩胛骨上旋和肩部被动活动范围：6周和12周后，两组在疼痛、残疾（两组的p=0.01；d=1.53和1.46）、肩胛骨上旋、肩关节屈曲（两组的p=0.02；d=2.2和0.92）、外展（p=0.04；d=0.07）和外旋（p=0.03；d=0.7）方面均有明显改善。然而，在一个疗程后，CG 在疼痛或残疾方面没有明显改善（分别为 p = 0.14 和 p = 0.16；两者的 d = 0.46）。在各组之间，6 周后（d = 0.81、d = 0.87、d = 0.67、d = 0.64 和 d = 0.69），EG 在疼痛、残疾、肩胛骨上旋、肩关节屈曲和外展（分别为 p = 0.02、p = 0.01、p = 0.02、p = 0.05 和 p = 0.04）方面均有明显改善（分别为 p = 0.02、p = 0.01、p = 0.02、p = 0.05 和 p = 0.04）：结论：研究结果表明，与物理治疗干预相比，添加 TSM 能为 AC 患者带来更好的临床疗效。然而，我们必须承认，我们的研究存在一个特定的局限性，那就是忽略了被动内旋的评估。这也是我们研究中的一个显著制约因素：泛非临床试验登记号："PACTR202303495421928"。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physiotherapy Theory and Practice REHABILITATION-

CiteScore

3.40

自引率

10.00%

发文量

300

期刊介绍： The aim of Physiotherapy Theory and Practice is to provide an international, peer-reviewed forum for the publication, dissemination, and discussion of recent developments and current research in physiotherapy/physical therapy. The journal accepts original quantitative and qualitative research reports, theoretical papers, systematic literature reviews, clinical case reports, and technical clinical notes. Physiotherapy Theory and Practice; promotes post-basic education through reports, reviews, and updates on all aspects of physiotherapy and specialties relating to clinical physiotherapy.