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  • Study: Mobilization With Movement Can Make a Difference in Shoulder Impingement

    A new study that attempts to isolate the effectiveness of mobilization with movement (MWM) for unilateral shoulder impingement concludes that the intervention can result in significant reduction in pain compared with a sham intervention. Authors believe that the more realistic use of MWM—not in isolation but as part of a multimodal physical therapy plan—could point to even better results for patients with shoulder impingement syndrome (SIS).

    For the study, recently published in the Journal of Manipulative and Physiological Therapeutics (abstract only available for free), researchers analyzed pain and range of motion results for 42 patients with SIS, half of whom received 4 10-minute sessions of a specific MWM application, and half who received a sham MWM-like intervention. Joshua A. Cleland, PT, DPT, OCS, FAAOMPT, was among the authors of the study.

    The actual MWM was performed by a physical therapist (PT) "with more than 10 years of experience in manual therapy," according to authors, who described the MWM technique as a process whereby "one hand was placed over the scapula posteriorly while the thenar eminence of the other hand was placed over the anterior aspect of the head of the humera." The patient is then asked to move his or her shoulder in flexion while the PT maintains a posterior-lateral manual glide on the humeral head. In each session, 3 sets of 10 repetitions were attempted, but the application was stopped if patients experienced pain.

    The sham MWM involved the PT placing one hand over the belly of the pectoralis major muscle and the other over the scapula without applying pressure. The patient was then asked to move his or her shoulder in the same way as the real MWM.

    Researchers measured pain free and maximum (painful) range of motion (ROM) in shoulder flexion, and pain-free ROM in shoulder extension, abduction, external rotation, and medial rotation at the start of the interventions and after 2 weeks.

    Their findings: patients who received the MWM experienced greater ROM in flexion and external rotation, and achieved a reduction in pain intensity during flexion—"significantly better outcomes" than the sham group, according to authors.

    Authors of the study write that the reasons for the improvement through MWM are "speculative" but offer the possibility that the force applied by the PT "diminished the abnormal translation of the humerus, which has been identified in individuals with shoulder problems."

    Researchers cited the fact that the study focused on MWM as a sole intervention as a limitation to their work. "In typical physical therapy practice, a multimodal treatment approach is often used," they write. "It is possible that combining MWM with other commonly used interventions including exercise and taping may result in greater improvements."

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    Comments

    • I gone through study article. It s very informative for doing research.

      Posted by Sreekanth. N on 11/26/2015 9:33 AM

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