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Effects of an anteroposterior mobilization of the glenohumeral joint in overhead athletes with chronic shoulder pain: a randomized controlled trial [with consumer summary]
Lluch E, Pecos-Martin D, Domenech-Garcia V, Herrero P, Gallego-Izquierdo T
Musculoskeletal Science & Practice 2018 Dec;38:91-98
clinical trial
8/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Passive oscillatory mobilizations are often employed by physiotherapists to reduce shoulder pain and increase function. However, there is little data about the neurophysiological effects of these mobilizations. OBJECTIVES: To investigate the initial effects of an anteroposterior (AP) shoulder joint mobilization on measures of pain and function in overhead athletes with chronic shoulder pain. DESIGN: Double-blind, controlled, within-subject, repeated-measures design. METHOD: Thirty-one overhead athletes with chronic shoulder pain participated. The effects of a 9-min, AP mobilization of the glenohumeral joint were compared with manual contact and no-contact interventions. Self-reported pain, pressure pain threshold (PPT), range of movement (ROM), muscle strength, and disability were measured immediately before and after each intervention. RESULTS/FINDINGS: No significant differences were found among the treatment conditions in any of the variables investigated. A significantly greater mean decrease in self-reported shoulder pain was observed following treatment condition (0.63 (0.12 to 1.14); p = 0.01). PPT at the affected shoulder increased significantly following both the treatment (0.23 (-0.43 to 0.02); p = 0.02) and manual contact (0.28 (-0.51 to 0.04); p = 0.01) conditions. Shoulder AP joint mobilization also increased PPT at a distal, non-painful site (0.42 (-0.85 to 0.01); p = 0.04). No changes were observed in shoulder ROM or muscle strength. CONCLUSIONS: This study found no superior effects in various pain or function-related outcome measures of a passive oscillatory anteroposterior mobilization applied to the glenohumeral joint compared to manual contact and no-contact interventions in overhead athletes with chronic shoulder pain. Some ability to modulate shoulder pain and local and widespread pain sensitivity was observed in the short term after the passive oscillatory anteroposterior mobilization.

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