The comparative effects of spinal and peripheral thrust manipulation and exercise on pain sensitivity and the relation to clinical outcome: a mechanistic trial using a shoulder pain model

The Journal of Orthopaedic and Sports Physical Therapy
Rogelio A CoronadoSteven Z George

Abstract

Single-blind randomized trial. To compare the effects of cervical and shoulder thrust manipulation (TM) and exercise on pain sensitivity, and to explore associations with clinical outcomes in patients with shoulder pain. Experimental studies indicate that spinal TM has an influence on central pain processes, supporting its application for treatment of extremity conditions. Direct comparison of spinal and peripheral TM on pain sensitivity has not been widely examined. Seventy-eight participants with shoulder pain (36 female; mean ± SD age, 39.0 ± 14.5 years) were randomized to receive 3 treatments of cervical TM (n = 26), shoulder TM (n = 27), or shoulder exercise (n = 25) over 2 weeks. Twenty-five healthy participants (13 female; mean ± SD age, 35.2 ± 11.1 years) were assessed to compare pain sensitivity with that in clinical participants at baseline. Primary outcomes were changes in local (eg, shoulder) and remote (eg, tibialis anterior) pressure pain threshold and heat pain threshold occurring over 2 weeks. Secondary outcomes were shoulder pain intensity and patient-rated function at 4, 8, and 12 weeks. Analysis-of-variance models and partial-correlation analyses were conducted to examine comparative effects and the relations...Continue Reading

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Citations

Nov 8, 2016·The Journal of Orthopaedic and Sports Physical Therapy·Rogelio A CoronadoSteven Z George
Jul 19, 2019·Shoulder & Elbow·Tom WalkerChris Littlewood
Mar 16, 2017·European Journal of Pain : EJP·C Fernández-de-Las-PeñasF Alburquerque-Sendín
Dec 15, 2016·Frontiers in Physiology·Matthew D JonesBenjamin K Barry
Dec 15, 2020·Journal of Neuroscience Research·Blake A KimmeyGregory Corder
Apr 28, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Kristian Damgaard LyngKristian Kjær Petersen

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