Abstract
Repetitive movements of the arm in or above the horizontal plane, can initiate the development of impingement syndrome of the shoulder (Wolin and Tarbet, 1997:56, 59). Impingement syndrome of the shoulder is a common problem, yet the diagnosis and management of it is still not completely understood. The purpose of this pilot study was to determine the most effective treatment protocol in the management of impingement syndrome of the shoulder due to supraspinatus tendonitis.
This randomised study consisted of three groups of ten patients, between the ages of eighteen and forty-five. All potential candidates for the trial were examined and admitted once all the exclusion and inclusion criteria had been met. Once joint restrictions were found in the cervical and/ or thoracic spine and the acromioclavicular joint, diversified chiropractic manipulative therapy was administered to all the patients. Group A received cervical and/ or thoracic spine manipulations, Group B received acromioclavicular joint manipulations, and Group C received a combination of spinal manipulations (cervical and/ or thoracic) and acromioclavicular joint manipulations.
Patients were treated over a two-week treatment period. Measurements were recorded on the first, third and sixth treatments. The objective data consisted of pain free shoulder abduction range of motion, the presence of a painful arc of the shoulder, a positive supraspinatus test and/or Neers and/or Hawkins impingement test. The subjective data included the numerical pain rating scale 101 questionnaire.
The statistical analysis that was conducted included the One Way ANOVA (analysis of variance) as well as the Student-Newman-Keuls Method to compare intra-group and inter-group data.
Statistically significant changes were seen in all three groups. However, group A (cervical and/ or thoracic spinal manipulations) and group B (acromioclavicular joint manipulations) showed to be the most effective in treating impingement syndrome of the shoulder. This does however require further research, and a larger sample size.
Dr. M. Moodley
Dr. G. Sher