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Manual physical therapy for injection-confirmed nonacute acromioclavicular joint pain.
Harris, Kevin D; Deyle, Gail D; Gill, Norman W; Howes, Robert R.
Affiliation
  • Harris KD; Army-Baylor University Doctoral Fellowship in Orthopaedic Manual Physical Therapy, Brooke Army Medical Center, Fort Sam Houston, TX, USA. kevin.65b.harris@gmail.com
J Orthop Sports Phys Ther ; 42(2): 66-80, 2012 Feb.
Article in En | MEDLINE | ID: mdl-22030329
ABSTRACT
STUDY

DESIGN:

Prospective single-cohort study.

OBJECTIVES:

To determine and document changes in pain and disability in patients with primary, nonacute acromioclavicular joint (ACJ) pain treated with a manual therapy approach.

BACKGROUND:

To our knowledge, there are no published studies on the physical therapy management of nonacute ACJ pain. Manual physical therapy has been successful in the treatment of other shoulder conditions.

METHODS:

The chief inclusion criterion was greater than 50% pain relief with an ACJ diagnostic injection. Patients were excluded if they had sustained an ACJ injury within the previous 12 months. Treatment was conducted utilizing a manual physical therapy approach that addressed all associated impairments in the shoulder girdle and cervicothoracic spine. The primary outcome measure was the Shoulder Pain and Disability Index. Secondary measures were the American Shoulder and Elbow Surgeon and global rating of change scales. Outcomes were collected at baseline, 4 weeks, and 6 months. The Shoulder Pain and Disability Index and American Shoulder and Elbow Surgeon scale values were analyzed with a repeated-measures analysis of variance.

RESULTS:

Thirteen patients (11 male; mean ± SD age, 41.1 ± 9.6 years) completed treatment consisting of an average of 6.4 sessions. Compared to baseline, there was a statistically significant and clinically meaningful improvement for the Shoulder Pain and Disability Index at 4 weeks (P = .001; mean, 25.9 points; 95% confidence interval [CI] 11.9, 39.8) and 6 months (P<.001; mean, 29.8 points; 95% CI 16.5, 43.0), and the American Shoulder and Elbow Surgeon scale at 4 weeks (P<.001; mean, 27.9 points; 95% CI 14.7, 41.1) and 6 months (P<.001; mean, 32.6 points; 95% CI 21.2, 43.9).

CONCLUSION:

Statistically significant and clinically meaningful improvements were observed in all outcome measures at 4 weeks and 6 months, following a short series of manual therapy interventions. These results, in a small cohort of patients, suggest the efficacy of this treatment approach but need to be verified by a randomized controlled trial. LEVEL OF EVIDENCE Therapy, level 4.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Acromioclavicular Joint / Physical Therapy Modalities / Pain Management Type of study: Clinical_trials / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: J Orthop Sports Phys Ther Year: 2012 Document type: Article Affiliation country: Estados Unidos

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Acromioclavicular Joint / Physical Therapy Modalities / Pain Management Type of study: Clinical_trials / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: J Orthop Sports Phys Ther Year: 2012 Document type: Article Affiliation country: Estados Unidos