Journal of International Academy of Physical Therapy Research (국제물리치료학회지)

International Academy of Physical Therapy Research (국제물리치료연구학회)
권호 표지
DOI QR코드

DOI QR Code

The Benefit of Thoracic Mobilization and Manipulation for Upper Thoracic Pain: A case study

  • Received : 2017.03.10
  • Accepted : 2017.04.12
  • Published : 2017.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this case study was to investigate the effects of thoracic mobilization and manipulation on a patient with upper thoracic pain. The subject had been complaining of upper thoracic pain for the last 4 months. On the X-ray, T3 and T4 spinous process were located on the left side of the vertical axis. First, transverse mobilization was applied from left to right at the T3-T4 and then thoracic manipulation was performed. The intervention methods of mobilization and manipulation were based on the concept of Maitland manual therapy. The subject underwent a total of 20 sessions (five times per week for four weeks). The thoracic pain and vertebral rotation angle were measured to examine the effect of the intervention. The thoracic pain score decreased (from 4.0 to 1.5) and the angle of thoracic vertebral rotation decreased (from $70{\underline{\circ}}$ to $4.0{\underline{\circ}}$). These results suggest that applied mobilization and manipulation in patients with a primary complaint of thoracic pain decreasing the thoracic pain and vertebral rotation angle.

Keywords

References

  1. Manchikanti L, Staats PS, Singh V, et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician 2003; 6: 3-80.
  2. Manchikanti L, Singh V, Dhensiatta S, et al. Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician 2009: 12; 35-70.
  3. Fruth SJ. Differential diagnosis and treatment in a patient with posterior upper thoracic pain. Phys Ther. 2006; 86: 254-68.
  4. Yoo WG. Effect of thoracic stretching, thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain. J Phys Ther Sci 2013; 25: 1509-10. https://doi.org/10.1589/jpts.25.1509
  5. Sahrmann SA. Diagnosis and treatment of movement impairment syndromes. ST. Louis, Mosby. 2002.
  6. Fryer G, Carub J, McIver S. The effect of manipulation and mobilization on pressure pain thresholds in the thoracic spine. Int J Osteopath Med 2004; 7(1): 8-14. https://doi.org/10.1016/S1443-8461(04)80003-0
  7. Cleland JA, Child MJD, McRae M, et al. Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial. Man Ther 2005; 10: 127-35. https://doi.org/10.1016/j.math.2004.08.005
  8. Gross AR, Kay TM, Kennedy C, et al. Clinical practice guidline on the use of manipulation or mobilization in the treatment of adults with mechanical neck disorders. Man Ther 2002: 7(4); 193-205. https://doi.org/10.1054/math.2002.0477
  9. Ferreira LAB, Santos LCF, Pereira WM, et al. Analysis of thoracic spine thrust manipulation for reducing neck pain. J Phys Ther Sci 2013: 25; 325-9. https://doi.org/10.1589/jpts.25.325
  10. Cleland JA, Glynn P, Whiteman JM, et al. Short-term effect of thrust versus nonthrust mobilization/ manipulation direct at thoracic spine in patients with neck pain: a randomized clinical trial. Phys Ther 2007; 87: 431-40. https://doi.org/10.2522/ptj.20060217
  11. Dunning JR, Cleand JA, Waldrop MA, et al. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: A multicenter randomized clinical trial. J Orthop Sports Phys Ther 2012: 42; 5-18. https://doi.org/10.2519/jospt.2012.3894
  12. Carlesso LC, Gross AR, Santaquida PL, et al. Adverse events associated with use of cervical manipulation and mobilization for the treatment of neck pain in adults: a systematic review. Man Ther 2010; 15: 434-44. https://doi.org/10.1016/j.math.2010.02.006
  13. Suvarnnato T, Puntumatakul R, Kaber D, et al. The effects of thoracic manipulation versus mobilization for chronic neck pain: a randomized controlled tial pilot study. J Phys Ther Sci 2013: 25; 865-71. https://doi.org/10.1589/jpts.25.865
  14. Powers CM, Krulig K, Harrison J, et al. Segmental mobility of the lumbar spine during a posterior to anterior mobilization: assessment using dynamic MRI. Clin Biomech 2003; 28: 80-3.
  15. McGregor C, Boyles R, Murahashi L, et al. The immediate effects of thoracic transverse mobilization in patients with the primary complaint of mechanical neck pain: a pilot study. J Man Manip Ther 2014; 22: 191-8. https://doi.org/10.1179/2042618614Y.0000000073
  16. Maitaland GD, Hengevled E, Banks K, et al. Maitland's vertebral manipulation, 7th Ed. New York: Elsevier Butterworth-Heinmann. 2005: 320-1.
  17. Hengeveld E, Banks K. Maitland's vertebral manipulation: management of neuromusculoskeletal disorders. Elsevier Health Science. 2013.
  18. Teys P, Bisset L, Vincenzino Bill. The initial effects of a Mulligan's mobilization with movement technique on range on movement and pressure pain threshold in pain-limited shoulders. Man Ther 2008; 13: 37-42. https://doi.org/10.1016/j.math.2006.07.011
  19. Couto IBVL. Efeito agudo da manipulacao em pacientes com dor lor lombar cronica: estudo piloto. Rev Fisio Mov 2007; 20: 57-62.
  20. Yang J, Lee B, Kim C. Changes proprioception and pain in patients with neck pain after thoracic anipulation. J Phys Ther Sci 2015; 27: 795-8. https://doi.org/10.1589/jpts.27.795
  21. Wright A. Hypoalgesia post manipulative therapy: a review of a potential neurophysiological mechanism. Mau Ther 1995; 1: 11-6. https://doi.org/10.1054/math.1995.0244
  22. Lee KJ, Roh JS, Choi HS, et al. Effect of active intervention after Kaltenborn's cervical joint mobilization on the cervical spine alignment and muscle activity in patients with forward head posture. J Korean Soc Phys Med 2015: 10(2); 17-27. https://doi.org/10.13066/kspm.2015.10.2.17
  23. Panjabi MM. Clinical spinal instability and low back pain. J Electromyogr Kinesiol 2003: 13; 371-9. https://doi.org/10.1016/S1050-6411(03)00044-0
  24. Shekelle PG. Spinal manipulation. Spine. 1994: 19; 858-61. https://doi.org/10.1097/00007632-199404000-00026
  25. Donovan JS, Kerber CW, Donovan WH, et al. Development of spontaneous intracranial hypotension concurrent with grade IV mobilization of the cervical and thoracic spine: a case report. Arch Phys Med Rehabil 2007: 88; 1472-3. https://doi.org/10.1016/j.apmr.2007.08.111