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The Effect of Mobilization of an Asymptomatic Cervical Spine on Shoulder Pain, Shoulder Range of Motion and Shoulder disability in Patients with Shoulder Pain


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1 M. A. Rangoonwala College of Physiotherapy and Research, Pune, India
     

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Introduction: Shoulder pain is a common complaint for individuals of all ages and activity levels with a prevalence ranging from 7% to 34%.Along with involvement of shoulder joint, dysfunction at the cervicothoracic spine and the adjacent ribs (also called the shoulder girdle) is considered to predict the recurrence and poor outcome of shoulder complaints. When shoulder joint is highly irritable, manual therapy cannot be given to it directly. Changes in the axio-scapular muscle activity during low-load functional tasks have been shown in individuals with chronic neck pain, which play an indirect role in shoulder biomechanics. Therefore, cervical spine mobilization techniques could be used during therapy to affect the more peripheral symptoms.

Materials and method: 60 patients with shoulder pain were randomly divided into 2 groups of 30 patients each. Group A received lateral and postero-anterior Maitland’s mobilization of the C5, C6 and C7 spinous processes along with Short Wave Diathermy (SWD) to the shoulder while Group B received SWD to the shoulder alone for 5 days. Passive range of motion of the shoulder using a universal goniometer, Pain on VAS and a Shoulder Pain and Disability Index scale were assessed pre and post treatment.

Conclusion: Mobilization of the asymptomatic cervical spine lead to a significant reduction of pain, significant increase in the overall shoulder ROM and a reduction in the functional disability after 5 days of treatment in individuals with shoulder pain. It has a lasting effect on improvement in functional disability. When two groups were compared (SWD + mobilization v/s SWD alone), no one group was statistically better than the other.


Keywords

Cervical Mobilization, Shoulder Pain, Asymptomatic Cervical Spine.
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  • Michael C. Koester, MD. Shoulder impingement syndrome. The American Journal of Medicine (2005) 118, 452–455.
  • Management of a Patient with Shoulder Pain and Disability: A Manual Physical Therapy Approach Addressing Impairments of the Cervical Spine and Upper Limb Neural Tissue.
  • Neviaser RJ. Painful conditions affecting the shoulder. Clinical Orthopedics Related Research. 1983 March; (173):63-9.
  • Karthikeyan Guru. Effect of gleno-humeral mobilization and mobilization of asymptomatic cervical spine in patients with shoulder impingement syndrome: A pilot trial. Saudi journal of Health Science 2015; 4:42-50.
  • Sobel JS. Physical examination of the cervical spine and shoulder girdle in patients with shoulder complaints. Journal of Manipulative and Physiological Therapeutic. 1997 May; 20 (4):257-62.
  • Bergman GD. Manipulative therapy in addition to usual medical care for patients with shoulder dysfunction and pain: a randomized, controlled trial. Annals of Internal Medicine. 2004 Sep 21; 141 (6):432-9.
  • Paul Mintken. Shoulder Pain and Regional Interdependence: Contributions of the Cervicothoracic Spine. Journal of Yoga & Physical Therapy.5:179. doi:10.4172/2157-7595.1000179.
  • Norlander S. Reduced mobility in the cervicothoracic motion segment--a risk factor for musculoskeletal neck-shoulder pain: a two-year prospective follow-up study. Scandinavian Journal of Rehabilitation Medicine [1997, 29(3):167-174].
  • Norlander S. Mobility in the cervico-thoracic motion segment: an indicative factor of musculoskeletal neck-shoulder pain. Scandinavian Journal of Rehabilitation Medicine[1996, 28(4):183-192]
  • Stiesch-Scholz M. Co-morbidity of internal derangement of the temporo-mandibular joint and silent dysfunction of the cervical spine. Journal of Oral Rehabilitation. 2003 Apr; 30 (4):386-91.
  • Eric J Hegedus. The neurophysiological effects of a single session of spinal joint mobilization: does the effect last? Journal of Manipulative Therapy. 2011 Aug; 19(3): 143–15
  • Geoff Maitland, et al. Maitland’s vertebral manipulation. 6th edition. 2001. Pages 4; 217. Cristiane Rodrigues Pedroni. Immediate effect of cervical mobilization in temporo-mandibular disorder patients. Braz J Oral Sci. 4(15):911-918
  • Geoffrey C. Goats. PhD, MCSP. Continuous shortwave (radio-frequency) diathermy. British journal of sports medicine. Vol. 23, No. 2.
  • Lynda McClatchie. Mobilizations of the asymptomatic cervical spine can reduce signs of shoulder dysfunction in adults. Manual Therapy August Volume 14, Issue 4, Pages 369–374.
  • M. Sterling. Cervical mobilization: concurrent effects on pain, sympathetic nervous system activity and motor activity. Manual therapy May Volume 6, Issue 2, Page 72–81.
  • Kanlayanaphotporn R, et al. Immediate effects of the central posteroanterior mobilization technique on pain and range of motion in patients with mechanical neck pain. Disabil Rehabil. 2010; 32(8):622-8.
  • Vanharanta, H.et al. Short-wave diathermy effects on S3-sulfate uptake and glycosaminoglycan concentration in rabbit knee tissue Arch Phys Med Rehabil. 1982, 63, 25-28.

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  • The Effect of Mobilization of an Asymptomatic Cervical Spine on Shoulder Pain, Shoulder Range of Motion and Shoulder disability in Patients with Shoulder Pain

Abstract Views: 683  |  PDF Views: 0

Authors

Ronika Agrawal
M. A. Rangoonwala College of Physiotherapy and Research, Pune, India
Gayatri Karandikar- Agashe
M. A. Rangoonwala College of Physiotherapy and Research, Pune, India

Abstract


Introduction: Shoulder pain is a common complaint for individuals of all ages and activity levels with a prevalence ranging from 7% to 34%.Along with involvement of shoulder joint, dysfunction at the cervicothoracic spine and the adjacent ribs (also called the shoulder girdle) is considered to predict the recurrence and poor outcome of shoulder complaints. When shoulder joint is highly irritable, manual therapy cannot be given to it directly. Changes in the axio-scapular muscle activity during low-load functional tasks have been shown in individuals with chronic neck pain, which play an indirect role in shoulder biomechanics. Therefore, cervical spine mobilization techniques could be used during therapy to affect the more peripheral symptoms.

Materials and method: 60 patients with shoulder pain were randomly divided into 2 groups of 30 patients each. Group A received lateral and postero-anterior Maitland’s mobilization of the C5, C6 and C7 spinous processes along with Short Wave Diathermy (SWD) to the shoulder while Group B received SWD to the shoulder alone for 5 days. Passive range of motion of the shoulder using a universal goniometer, Pain on VAS and a Shoulder Pain and Disability Index scale were assessed pre and post treatment.

Conclusion: Mobilization of the asymptomatic cervical spine lead to a significant reduction of pain, significant increase in the overall shoulder ROM and a reduction in the functional disability after 5 days of treatment in individuals with shoulder pain. It has a lasting effect on improvement in functional disability. When two groups were compared (SWD + mobilization v/s SWD alone), no one group was statistically better than the other.


Keywords


Cervical Mobilization, Shoulder Pain, Asymptomatic Cervical Spine.

References