Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Musculoskeletal Disorders

Background: Shoulder impingement syndrome (SIS) is the most common cause of shoulder pain. Recently, attention has been given to the use of spinal manual therapy to treat shoulder pain. Clinical evidence has shown that spinal manual therapy is a common therapeutic approach used to address extremity dysfunction like sis. objective: to investigate whether mobilization directed at cervicothoracic spine is more beneficial than treatment directed solely at the shoulder for patients with sis on pain, function, scapular kinematics, and scapular and shoulder muscle strength ratio. methods: thirty-five male and female patients aged between 20 and 45 years old were participated in this study as sis (stage i and ii neer{u2019}s classification). the selected subjects were randomly assigned in to control and experimental groups group (a) control group received only treatment based on the most evidence-based treatment for sis (stretching of the posterior capsule, rotator cuff strengthening, and scapular muscle training), group (b) experimental group received maitland{u2019}s rhythmic oscillatory central poster anterior (pa) and transverse mobilization of cervicothoracic spine (c7-t4 vertebra) as tolerated by patient with addition same pt program received by group a for a periods of 4 weeks. before and after the treatment, pain level and shoulder disability were measured by shoulder pain and disability index (spadi), shoulder and scapular isometric muscle strength measured by hand held dynamometer (hhd) device, scapular upward rotation was measured in 3 positions: 0 , 90 , and 180 of elevation in the scapular plane by baseline bubble inclinometer, scapular protraction was measured by acromion to table distance (a-t distance)

Issued also as CD