Immediate Effects of Thoracic Spine Manipulation Upon Shoulder Functionality in Patients With Sutured Rotator Cuff Repair: A Prospective Study

J Manipulative Physiol Ther. 2018 Sep;41(7):589-595. doi: 10.1016/j.jmpt.2018.02.005.


Objectives: The purpose of this study was to evaluate the immediate effect of thoracic spine manipulation upon active flexion and abduction mobility of the shoulder, spine temperature, and the size of the subacromial space as measured by ultrasound in 3 positions (internal, neutral, and external rotation) of the glenohumeral joint in patients who have undergone surgery because of subacromial impingement.

Methods: Quasi-experimental, prospective, short-term effect study with consecutively sampled participants. Thirty-two patients had undergone subacromial decompression together with supraspinatus tendon suture. The following variables were studied: age, sex, dominant shoulder, presurgery evolution time, working status, surface temperature of dorsal segment with limited mobility, premanipulation functional assessment using the Spanish version of the Upper Limb Functional Index Scale, goniometric range of motion measurement at glenohumeral joint before and after manipulation, and ultrasound measurement of subacromial space before and after manipulation.

Results: Significant differences and small effect size were found in measurements for flexion and abduction movements after thoracic spine manipulation (P > .001; ES > 0.2) and subacromial space measurements in neutral rotation and external rotation (P > .001), but without clinical relevance effect size (<0.2).

Conclusions: Active shoulder flexion and abduction mobility increase after manipulation of thoracic spine in patients who have undergone surgery for rotator cuff suture. Subacromial space increases significantly with shoulder in neutral and external rotation position after manipulation. No differences were found regarding surface temperature of manipulated area.

Keywords: Manipulation, Spinal; Rotator Cuff; Shoulder; Thoracic Vertebrae; Ultrasonography.

MeSH terms

  • Adult
  • Decompression, Surgical
  • Female
  • Humans
  • Male
  • Manipulation, Spinal*
  • Middle Aged
  • Prospective Studies
  • Range of Motion, Articular / physiology
  • Rotator Cuff / surgery*
  • Shoulder Impingement Syndrome / surgery*
  • Shoulder Joint / diagnostic imaging*
  • Shoulder Joint / physiopathology*
  • Thoracic Vertebrae / physiology*
  • Ultrasonography