CPR for Cervicothoracic Manipulation and Shoulder Pain
Purpose[edit | edit source]
To identify prognostic factors for individuals with shoulder pain likely to experience improvements in pain and disability following the application of cervicothoracic spine thrust and nonthrust manipulation.
Rule[edit | edit source]
The following five criteria are considered predictors of improved short term shoulder pain prognosis following cervicothoracic manpulation:
1. Pain-free shoulder flexion < 120˚
2. Shoulder internal rotation < 53˚ @ 90˚ of abduction
3. Negative Neer’s Test
4. Not taking medications for their shoulder pain
5. Symptoms < 90 days
Diagnostic values of results (95% Confidence Intervals) are as follows:
| Number of Positive Criteria |
Sensitivity |
Specificity |
Positive Likelihood Ratio |
Probability of Success(%)a |
|
Met at least 1 |
1.0 (0.90, 1.0) |
0.19 (0.08, 0.38) |
1.0 (1.2, 1.5) |
61 |
| Met at least 2 |
0.90 (0.77, 0.96) |
0.61 (0.42, 0.78) |
2.3 (1.5, 3.6) |
78 |
| Met at least 3 |
0.51 (0.37, 0.65) |
0.90 (0.73, 0.97) |
5.3 (1.7, 16.0) |
89 |
| Met at least 4 |
0.27 (0.15, .41) |
1.0 (0.86, 1.0) |
∞ |
100 |
| Met all 5 |
0.04 (0.01, 0.15) |
1.0 (0.86, 1.0) |
∞ |
100 |
Table[edit | edit source]
Evidence[edit | edit source]
==
Interventions[edit | edit source]
Manual Techniques for the Cervicothoracic Spine
References[edit | edit source]
Mintken PE, Cleland JA, Carpenter KJ, Bieniek ML, Keirns M, Whitman JM. Some Factors Predict Short-Term Outcomes in Individuals with Shoulder Pain Receiving Cervicothoracic Manipulation: A Single-Arm Trial. Phys Ther. 2010; 90(1): 26-42.
