Abstract
M.Tech.
PURPOSE: Impingement syndrome of the shoulder is a very 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 chiropractic treatment protocol in the
management of impingement syndrome due to supraspinatus tendonitis. This was done
by comparing objective and subjective measures gained during a treatment protocol
consisting either of administering corrective chiropractic manipulative therapy to the
cervical spine and/or the thoracic spine, to the glenohumeral joint or to both of these
areas.
METHODS: This randomised controlled trial consisted of three groups of fifteen
patients, each between the ages of eighteen and forty-five years old. All potential
candidates were examined and cleared for participation in the clinical trials subsequent to
a selection process and X-ray examination if necessary. Diversified chiropractic
manipulative techniques were used for all patients provided joint restrictions were
detected. Group A received glenohumeral joint manipulations, Group B received spinal
manipulations and Group C received a combination of spinal and glenohumeral joint
manipulations.
PROCEDURE: Patients were treated for six consultations over a two-week period. A
follow-up appointment was scheduled for four weeks after that in order to determine the
lasting effects of the treatment protocol. At the first, third, sixth and follow-up visit,
measurements were recorded. Objective data included pain free shoulder abduction range
of motion, the presence of a painful arc of the shoulder and the presence of a positive
supraspinatus test. Subjective data included the numerical pain rating scale-101 scores.
RESULTS: statistical analysis was conducted using the parametric One Way ANOVA
(analysis of variance) and unpaired t-tests as well as the non-parametric Kruskal-Wallis
One Way ANOVA on Ranks and Mann-Whitney Rank Sum tests to compare intragroup
and intergroup data.
III
CONCLUSIONS: Although all three groups showed numerical improvements throughout
the treatment period, only group A showed statistically significant improvements. This
study therefore suggests that manipulation of the glenohumeral joint is more effective in
the treatment of impingement syndrome of the shoulder with regard to short-term as well
as long-term symptomatic relief. This however requires further research, as a larger
sample size is required