The Immediate Effects of First Rib Mobilization on Pain and Range of Motion in Patients With Shoulder Pain

Study Purpose

The purpose of this clinical trial is to examine whether one session of a specific manual physical therapy technique, known as first rib mobilization, can lead to immediate improvements in pain and movement in individuals with shoulder pain. We hypothesize that this single treatment will result in reduced pain and increased ability to move the shoulder and neck. Researchers will compare first rib mobilization to a sham mobilization (a look-alike hands-on position that does not mobilize the first rib) to see if first rib mobilization works to immediately reduce pain and improve movement in patients with shoulder pain. Participants will receive first rib mobilization or a sham mobilization during a single session of physical therapy and will receive pre and post intervention measurements of their pain levels and neck and shoulder range of motion.

Recruitment Criteria

Accepts Healthy Volunteers Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms	No
Study Type An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes. An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes. Searching Both is inclusive of interventional and observational studies.	Interventional
Eligible Ages	18 Years - 75 Years
Gender	All

More Inclusion & Exclusion Criteria

Inclusion Criteria:

- Men and Women.

- Ages 18-75 years old.

- Attending physical therapy.

- Primary complaint of shoulder pain.

- Pain intensity >3/10 on the Numeric Pain Rating Scale (NPRS) - A Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick DASH) score greater than 16% impaired.

Exclusion Criteria:

- Previous shoulder or neck surgery.

- Clinical signs of a full rotator cuff tear (positive drop arm test) - Having positive MRI findings of a complete rotator cuff tear.

- Having a positive Spurling's test.

- Having a steroid injection in the cervical spine and/or shoulder in the last two months.

- Having any red flags (history of cancer, upper motor neuron disorder, fractures, osteoporosis, acute inflammatory process) - Expressing fear/anxiety related to receiving manual therapy treatment

Trial Details

Trial ID: This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.	NCT07064772
Phase Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans. Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data. Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs. Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.	N/A
Lead Sponsor The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.	Andrews University
Principal Investigator The person who is responsible for the scientific and technical direction of the entire clinical study.	N/A
Principal Investigator Affiliation	N/A
Agency Class Category of organization(s) involved as sponsor (and collaborator) supporting the trial.	Other
Overall Status	Not yet recruiting
Countries	United States
Conditions The disease, disorder, syndrome, illness, or injury that is being studied.	Shoulder Pain

Arms & Interventions

Arms

Experimental: First Rib Mobilization Group

Participants in this arm will be randomly assigned to receive a first rib mobilization on their affected side of shoulder pain by a licensed physical therapist.

Sham Comparator: Sham Mobilization

Participants in this arm will be randomly assigned to receive a sham mobilization to the region of the first rib on their affected side of shoulder pain by a licensed physical therapist.

Interventions

Other: - First Rib Mobilization

Participants in the mobilization group will receive either a seated or supine three stage progressive muscle energy technique (MET) plus a singular high-velocity, low-amplitude thrust (HVLAT) mobilization technique directed to their first rib on their symptomatic side based on the discretion of the treating physical therapist.

Other: - Sham Comparator

Participants in the sham mobilization (control) group will be placed in a supine, hook-lying position identical to the mobilization group; however, they will be instructed to inhale and exhale 3 times using diaphragmatic breathing (avoiding upper chest recruitment) as the physical therapist gently rests his or her hand over the area of the upper trapezius muscle just proximal to the first rib to simulate a sham mobilization hand placement. Therefore, physical therapists will not use any significant compressive force to the musculature, perform any tactile cueing for upper chest breathing, perform any mobilizations, nor perform any HVLAT techniques to participants in the sham mobilization group.

Contact a Trial Team

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Lebanon Valley College, Annville, Pennsylvania

Status

Address

Lebanon Valley College

Annville, Pennsylvania, 17003

Site Contact

Michael L Fink, Doctor of Science

[email protected]

717-867-6847

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