A Randomized, Controlled Trial
Background
Dysfunction of the cervicothoracic spine and the adjacent ribs (also called the shoulder girdle) is considered to predict occurrence and poor outcome of shoulder symptoms. It can be treated with manipulative therapy, but scientific evidence for the effectiveness of such therapy is lacking.
Objective
To study the effectiveness of manipulative therapy for the shoulder girdle in addition to usual medical care for relief of shoulder pain and dysfunction.
Design
Randomized, controlled trial.
Setting
General practices in Groningen, the Netherlands.
Patients
150 patients with shoulder symptoms and dysfunction of the shoulder girdle.
Interventions
All patients received usual medical care from their general practitioners. Only the intervention group received additional manipulative therapy, up to 6 treatment sessions in a 12-week period.
Measurements
Patient-perceived recovery, severity of the main complaint, shoulder pain, shoulder disability, and general health. Data were collected during and at the end of the treatment period (at 6 and 12 weeks) and during the follow-up period (at 26 and 52 weeks).
Results
During treatment (6 weeks), no significant differences were found between study groups. After completion of treatment (12 weeks), 43% of the intervention group and 21% of the control group reported full recovery. After 52 weeks, approximately the same difference in recovery rate (17 percentage points) was seen between groups. During the intervention and follow-up periods, a consistent between-group difference in severity of the main complaint, shoulder pain and disability, and general health favored additional manipulative therapy.
Limitations:
The sample size was small, and assessment of end points was subjective.
Conclusion:
Manipulative therapy for the shoulder girdle in addition to usual medical care accelerates recovery of shoulder symptoms.
September 2004 issue of Annals of Internal Medicine | Volume 141 Issue 6| Pages 432-439
Background
Dysfunction of the cervicothoracic spine and the adjacent ribs (also called the shoulder girdle) is considered to predict occurrence and poor outcome of shoulder symptoms. It can be treated with manipulative therapy, but scientific evidence for the effectiveness of such therapy is lacking.
Objective
To study the effectiveness of manipulative therapy for the shoulder girdle in addition to usual medical care for relief of shoulder pain and dysfunction.
Design
Randomized, controlled trial.
Setting
General practices in Groningen, the Netherlands.
Patients
150 patients with shoulder symptoms and dysfunction of the shoulder girdle.
Interventions
All patients received usual medical care from their general practitioners. Only the intervention group received additional manipulative therapy, up to 6 treatment sessions in a 12-week period.
Measurements
Patient-perceived recovery, severity of the main complaint, shoulder pain, shoulder disability, and general health. Data were collected during and at the end of the treatment period (at 6 and 12 weeks) and during the follow-up period (at 26 and 52 weeks).
Results
During treatment (6 weeks), no significant differences were found between study groups. After completion of treatment (12 weeks), 43% of the intervention group and 21% of the control group reported full recovery. After 52 weeks, approximately the same difference in recovery rate (17 percentage points) was seen between groups. During the intervention and follow-up periods, a consistent between-group difference in severity of the main complaint, shoulder pain and disability, and general health favored additional manipulative therapy.
Limitations:
The sample size was small, and assessment of end points was subjective.
Conclusion:
Manipulative therapy for the shoulder girdle in addition to usual medical care accelerates recovery of shoulder symptoms.
September 2004 issue of Annals of Internal Medicine | Volume 141 Issue 6| Pages 432-439
Artigo Científico - Terapia Manipulativa em adição ao cuidado médico usual para pacientes com Disfunção de Ombro e Dor
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Manipulative Therapy in Addition to Usual Medical Care for Patients with Shoulder Dysfunction and Pain
Gert J.D. Bergman, MSc; Jan C. Winters, PhD, MD; Klaas H. Groenier, MSc; Jan J.M. Pool; Betty Meyboom-de Jong, PhD, MD; Klaas Postema, PhD, MD; and Geert J.M.G. van der Heijden, PhD
Gert J.D. Bergman, MSc; Jan C. Winters, PhD, MD; Klaas H. Groenier, MSc; Jan J.M. Pool; Betty Meyboom-de Jong, PhD, MD; Klaas Postema, PhD, MD; and Geert J.M.G. van der Heijden, PhD