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Immediate effects of thoracic manipulation on scapular 3D kinematics during arm elevation in young healthy subjects

Abstract

It is believed that mobility and posture of the thoracic spine may influence, directly, the scapulothoracic and glenohumeral kinematics. Few studies demonstrated alteration in scapular kinematics during arm elevation in subjects with increased thoracic kyphosis. There are evidences that reduced mobility of the upper segments of the thoracic spine may be associated with pain in the shoulder and neck. Many investigations have evaluated the effectiveness of thoracic manipulation in skeletal muscle disorders. Although some studies have demonstrated the effectiveness of thoracic manipulation in decreasing pain and increasing shoulder range of motion, there is lack of studies that evaluate the effects of thoracic manipulation on 3-D scapular kinematics. As such, the purpose of this study is to verify the immediate effects of the thoracic manipulation on 3-D shoulder kinematics during arm elevation in healthy subjects. Forty healthy subjects, both genders and without shoulder dysfunctions, will participate in this study. They will be randomly divided in 2 groups: thoracic manipulation group and sham group. The thoracic manipulation will be performed with the patient in the seated position and with the arms crossed over the chest and hands passed over the shoulders. The therapist will place his upper chest at the level of the patient's middle thoracic spine and grasp the patient's elbows. Gentle flexion of the thoracic spine will be introduced until slight tension is felt (end feel) in the tissues at the contact point between the therapist's chest and patient's back. Then, a distraction thrust manipulation in an upward and anterior-posterior direction will be applied. The sham group will be positioned similarly to the thoracic manipulation group, but the manipulation (high velocity, low amplitude) will not performed. Kinematic data will be collected with the subjects in a relaxed standing position. Initially, a rest position will be recorded. Then, 3 repetitions of arm elevation in the sagittal plane will be performed pre-manipulation, and another rest position will be recorded. Afterwards, the manipulation will be recorded. Again, the anterior stage will be repeated (rest, arm elevation, rest). The dependent variables were the 3-D scapular kinematic values (internal rotation, upward rotation and tilting) which were analyzed with reference to the trunk. For each dependent variable, data will analyzed with a three-way repeated measure ANOVA with main effects of angle of arm elevation (initial position, 30°, 60°, 90°, 120°); test (pre and post-manipulation) and group (thoracic manipulation and sham). A P value of less than 0.05 was considered significant. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ROSA, DAYANA P.; ALBURQUERQUE-SENDIN, FRANCISCO; SALVINI, TANIA F.; CAMARGO, PAULA R.. EFFECT OF SEATED THORACIC MANIPULATION ON CHANGES IN SCAPULAR KINEMATICS AND SCAPULOHUMERAL RHYTHM IN YOUNG ASYMPTOMATIC PARTICIPANTS: A RANDOMIZED STUDY. JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS, v. 36, n. 8, p. 546-554, . (10/18124-0, 10/18439-0)

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