El Melhat Ahmed M, Abbas Rami L, Zebdawi Moustafa R, Ali Ismail Ali Mohamed
Department of Physical Therapy for Musculoskeletal Disorders and Their Surgeries, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
Department of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
Physiother Theory Pract. 2025 Jan;41(1):65-78. doi: 10.1080/09593985.2024.2316897. Epub 2024 Feb 14.
Research is supporting thoracic spine manipulation (TSM) as an intervention in treating adhesive capsulitis (AC) when coupled with physical therapy interventions.
To investigate whether TSM improves AC outcomes when combined with physical therapy interventions.
A double-blinded, randomized, controlled trial with 40 patients assigned into two groups. The experimental group (EG) received physical therapy intervention and TSM; the control group (CG) had physical therapy with sham manipulation. Both groups received interventions biweekly for 12 weeks. Outcomes included Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), scapular upward rotation, and shoulder passive range of motion conducted at baseline, after 1 session, 6 and 12 weeks.
Both groups improved significantly after 6 and 12 weeks in pain, disability ( = 0.01 for both; d = 1.53 and 1.46, respectively), scapular upward rotation, shoulder flexion ( = 0.02 for both; d = 2.2 and 0.92, respectively), abduction ( = 0.04; d = 0.07), and external rotation ( = 0.03; d = 0.7). However, CG showed no significant improvement in pain or disability after one session ( = 0.14 and = 0.16, respectively; d = 0.46 for both). Between groups, results favored EG significantly in pain, disability, scapular upward rotation, shoulder flexion, and abduction ( = 0.02, = 0.01, = 0.02, = 0.05, and = 0.04, respectively) at 6 weeks (d = 0.81, d = 0.87, d = 0.67, d = 0.64, and d = 0.69, respectively).
The results suggest that adding TSM yielded superior clinical benefits when compared to physical therapy interventions in AC patients. Nevertheless, it is imperative to acknowledge a specific limitation in our study is the omission of passive internal rotation assessment. This aspect represents a notable constraint in our research.
Pan African clinical trial registry "".
研究支持在结合物理治疗干预时，胸椎整复术（TSM）可作为治疗粘连性关节囊炎（AC）的一种干预措施。
研究TSM与物理治疗干预相结合时是否能改善AC的治疗效果。
一项双盲、随机对照试验，将40例患者分为两组。实验组（EG）接受物理治疗干预和TSM；对照组（CG）接受物理治疗及假手法治疗。两组均每两周接受一次干预，为期12周。观察指标包括视觉模拟评分法（VAS）、肩痛和功能障碍指数（SPADI）、肩胛骨上旋以及在基线、1次治疗后、6周和12周时进行的肩关节被动活动范围。
两组在6周和12周后疼痛、功能障碍（两者均P = 0.01；d分别为1.53和1.46）、肩胛骨上旋、肩关节前屈（两者均P = 0.02；d分别为2.2和0.92）、外展（P = 0.04；d = 0.07）和外旋（P = 0.03；d = 0.7）方面均有显著改善。然而，CG在一次治疗后疼痛或功能障碍方面无显著改善（分别为P = 0.14和P = 0.16；d均为0.46）。在组间比较中，6周时EG在疼痛、功能障碍、肩胛骨上旋、肩关节前屈和外展方面的结果显著优于CG（分别为P = 0.02、P = 0.01、P = 0.02、P = 0.05和P = 0.04）（d分别为0.81、0.87、0.67、0.64和0.69）。
结果表明，与物理治疗干预相比，在AC患者中添加TSM产生了更好的临床效益。然而，必须承认我们研究中的一个特定局限性是遗漏了被动内旋评估。这一方面是我们研究中的一个显著限制。
泛非临床试验注册中心“”
