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Table 2 Descriptive characteristics of the included studies assessing treatments for subacromial impingement syndrome

From: A systematic review of thrust manipulation for non-surgical shoulder conditions

Author & Year Study Design Participantsa Diagnosis Treatment Frequency Data collection Intervention Comparison Outcome Measures Results
Kardouni et al. 2015 [39] RCT n = 52; mean age active group 30.8 ± 11.9; mean age sham group 33.2 ± 12.6 3 of 5 positive signs or in-office exam findings 1 treatment Pre, post & 24–48 h post-treatment Active thoracic SMT; prone lower, mid- and seated upper thoracic treatment (x2) for a total of 6 SMT maneuvers Sham thoracic SMT with identical positioning NPRSc
(0–10)
PSSd, b
(0–100)
Pre-post mean change: active group, −0.9; sham group, −1.2; main effect within group (p < 0.001); between group (p = .74)
Pre-post mean change: active group, 8.6; sham group, 9.3; main effect within group (p < 0.001); between group (p = .89)
Kardouni et al. 2015 [38] RCT n = 45; mean age active group 31.1 ± 12.3; mean age sham group 31.2 ± 12.1 5 of 7 positive signs or in-office exam findings 1 treatment Pre, post & 24–48 h post-treatment Active thoracic SMT; prone lower, mid- and seated upper thoracic treatment (x2) for a total of 6 SMT maneuvers Sham thoracic SMT with identical positioning NPRSe
(0–10)
PSSf, b
(0–100)
Pre-post mean change: active group, −0.9; sham group, −1.5; main effect within group (p < 0.001); between group (p = .28)
Pre-post mean change: active group, 9.2; sham group, 11.0; main effect within group (p < 0.001); between group (p = .52)
Haik et al. 2014 [41] RCT n = 50; mean age active group 33.8 ± 12.2; mean age sham group 29.7 ± 9.3 3 of 7 positive signs or in-office exam findings 1 treatment Pre and Post Active thoracic SMT; seated mid-thoracic manipulation Sham thoracic SMT NPRSg
(0–10)
Pre-post mean change: active group, −0.8; sham group, −0.2; main effect within group (p = .004); between group (p = .11)
Munday et al. 2007 [40] RCT n = 30; group A mean age 23 (range 19–32); group B mean age 22 (range 16–38) 3 of 4 positive signs or in-office exam findings 8 treatments in 3 weeks Baseline (1st visit), 3 weeks (8th treatment) & 1-month follow-up Group B (n = 15): thrust manipulation (AC joint or GH joint; if necessary, scapula or ribs) Group A (n = 15): detuned ultrasound VASh
(100 mm)
SFMPQh
Pre-post mean change within groups: group A, −29.17 (p ≤ .05); group B, −27.24 (p ≤ .05)
Mean differences between groups: −9.1 (p = .019)
Pre-post mean change within groups: group A, −10.77 (p ≤ .05); group B, −24.01 (p ≤ .05)
Mean differences between groups: −8.4 (p = .005)
Boyles et al. 2009 [42] Non-randomized study n = 56; mean age 31.2 ± 8.9 ≥2 NPRS plus + Neer or Hawkins-Kennedy and ≥2 NPRS on active shoulder abduction or on resisted test (internal or external rotation; empty can) 1 treatment Pre and Post Thoracic SMT; seated mid-thoracic and cervicothoracic junction; supine rib manipulation (if required) N/A NPRSi
(0–10)
SPADIi
(0–100)
Pre-post mean change: Neer, −1.1 (p = .001); Hawkins, −1.2 (p < 0.001); resisted EC, −0.8 (p = .007); resisted IR,
−0.6 (p = .008); resisted ER, −1.0 (p < 0.001); active ABD, −0.8 (p = .001)
Pre-post mean change: −6.8 (p < 0.001)
Muth et al. 2012 [43] Non-randomized study n = 30; mean age 30.6 ± 7.9 ≥3 NPRS on performance of Hawkins-Kennedy, Neer, or Jobe tests 1 treatment Pre, post & 7–10 days post-treatment Thoracic SMT; seated mid-thoracic (focus on apex of the thoracic kyphosis) and cervicothoracic junction N/A NPRSj (0–10)
PSSk, b
(0–100)
Pre-post mean change: Jobe, −2.6 (p < 0.001); Neer, −2.6 (p < 0.001); Hawkins, −2.8 (p < 0.001); cervical rotation, −0.4 (p = .04)
Pre-post mean change: 7.6 ± 9.3 CI (4.1,11.1), (p < 0.001)
  1. RCT randomized controlled trial, SMT thrust spinal manipulative therapy, NPRS numeric pain rating scale, PSS Penn shoulder score, VAS visual analog scale, SFMPQ short-form McGill pain questionnaire, EC empty can, IR internal rotation, ER external rotation, ABD abduction, SPADI shoulder pain and disability index, CI confidence interval, ROM range of motion, EMG electromyo-graphy
  2. aMean age ± SD
  3. bA higher score is better
  4. cSecondary outcome assessed at baseline, immediately post-treatment, and at 24–48 h follow-up; primary outcome was thoracic motion
  5. dSecondary outcome assessed at baseline and at 24–48 h follow-up; primary outcome was thoracic motion
  6. eSecondary outcome assessed at baseline, immediately post-treatment, and at 24–48 h follow-up; primary outcome was pain pressure threshold
  7. fSecondary outcome assessed at baseline and at 24–48 h follow-up; primary outcome was pain pressure threshold
  8. gPrimary outcome assessed pre- and immediately post-treatment; another primary outcome was scapular kinematics
  9. hPrimary outcome assessed at baseline, week 3 and at 1-month follow-up; another primary outcome was pain pressure threshold
  10. iPrimary outcome assessed at baseline and at 48-h follow-up; secondary outcome was Global Rating of Change Scale
  11. jSecondary outcome assessed at baseline and immediately post-treatment; other secondary outcomes included force production and ROM; primary outcomes were scapular kinematics and EMG
  12. kSecondary outcome assessed at 7–10 days follow-up; result mean change ± SD; other secondary outcomes included force production and ROM; primary outcomes were scapular kinematics and EMG