Boyles Robert E, Ritland Bradley M, Miracle Brian M, Barclay Daniel M, Faul Mary S, Moore Josef H, Koppenhaver Shane L, Wainner Robert S
School of Physical Therapy, University of Puget Sound, 1500N Warner St, Tacoma, WA 98416, USA.
Man Ther. 2009 Aug;14(4):375-80. doi: 10.1016/j.math.2008.05.005. Epub 2008 Aug 15.
The study was an exploratory, one group pretest/post-test study, with the objective of investigating the short-term effects of thoracic spine thrust manipulations (TSTMs) on patients with shoulder impingement syndrome (SIS). There is evidence that manual physical therapy that includes TSTM and non-thrust manipulation and exercise is effective for the treatment of patients with SIS. However, the relative contributions of specific manual therapy interventions are not known. To date, no published studies address the short-term effects of TSTM in the treatment of SIS. Fifty-six patients (40 males, 16 females; mean age 31.2+/-8.9) with SIS underwent a standardized shoulder examination, immediately followed by TSTM techniques. Outcomes measured were the Numeric Pain and Rating Scale (NPRS) and the Shoulder Pain and Disability Index (SPADI), all collected at baseline and at a 48-h follow-up period. Additionally, the Global Rating of Change Scale (GRCS) was collected at 48-h follow-up to measure patient perceived change. At 48-h follow-up, the NPRS change scores for Neer impingement sign, Hawkins impingement sign, resisted empty can, resisted external rotation, resisted internal rotation, and active abduction were all statistically significant (p<0.01). The reduction in the SPADI score was also statistically significant (p<0.001) and the mean GRCS score=1.4+/-2.5. In conclusion, TSTM provided a statistically significant decrease in self reported pain measures and disability in patients with SIS at 48-h follow-up.
本研究为一项探索性的单组前后测研究，旨在调查胸椎推力手法（TSTM）对肩峰撞击综合征（SIS）患者的短期影响。有证据表明，包括TSTM、非推力手法及运动的手法物理治疗对SIS患者的治疗有效。然而，具体手法治疗干预措施的相对作用尚不清楚。迄今为止，尚无已发表的研究探讨TSTM治疗SIS的短期效果。56例SIS患者（40例男性，16例女性；平均年龄31.2±8.9岁）接受了标准化的肩部检查，随后立即采用TSTM技术。测量的结果指标为数字疼痛评分量表（NPRS）和肩痛与功能障碍指数（SPADI），均在基线和48小时随访期收集。此外，在48小时随访时收集整体变化评定量表（GRCS）以测量患者感知的变化。在48小时随访时，Neer撞击征、Hawkins撞击征、抗阻空罐试验、抗阻外旋、抗阻内旋和主动外展的NPRS变化评分均具有统计学意义（p<0.01）。SPADI评分的降低也具有统计学意义（p<0.001），平均GRCS评分为1.4±2.5。总之，在48小时随访时，TSTM使SIS患者自我报告的疼痛指标和功能障碍有统计学意义的下降。
