Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 20360
  Title A randomized controlled trial to assess the efficacy of shoulder manipulation vs. placebo in the treatment of shoulder pain due to rotator cuff tendinopathy [clinical trial; randomized controlled trial]
Journal JACA Online. 2008 Dec;45(9):Online access only p 11-26
Peer Review Yes
Publication Type Randomized Controlled Trial
Abstract/Notes Introduction: Shoulder pain is common, but the best treatment for it is yet to be determined. This randomized, placebo-controlled trial of manipulation (high-velocity, low-amplitude shoulder adjustment) vs. placebo (sham laser) was designed to assess the efficacy of manipulation in the treatment of rotator cuff tendinopathy.

Materials and Methods: Eighty-six patients were screened, and 60 volunteers, 30 per group (average age 42, range 18 to 76 years) with a diagnosis of rotator cuff tendinopathy (supraspinatus tendinopathy) were randomized into two groups. Outcome measures included the Numerical Pain Rating Scale-101 (NRS-101), algometry, and goniometry. Full power was calculated at 95%, requiring a sample size of N=144 with a set at p=0.05.

Results: The unpaired t-test demonstrated a significant difference in favor of adjusting (Group 1) for algometry and goniometry (p=0.05). Friedman’s test, however, determined that for Group 1, there were statistically significant and clinically meaningful decreases in the NRS-101 and significantly increased global range of motion (ROM) at final consultation in flexion, extension, abduction, adduction, external rotation, and horizontal abduction (all p<0.05). Five patients dropped out and were replaced in the placebo group; none dropped out in the adjustment group. There were no serious adverse events. Blind assessors, longer follow-up, and functional outcome measures will improve future studies.

Conclusion: In this study, shoulder manipulation appeared efficacious (algometry, goniometric ROM) in short-term relief of rotator cuff tendinopathy vs. placebo (p=0.05). Regarding within-group change, there were also statistically significant and clinically meaningful decreased pain and increased global ROM with shoulder manipulation (p=0.05). Without full power, these data must be viewed with caution, but the results clearly merit further research.

This abstract is reproduced with permission of the publisher. Full text is available by subscription.

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