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Takatalo J.1,2, Leinonen T.3, Rytkönen M.3, Lausmaa M.4, Ylinen J.5, Häkkinen A.1
1University of Jyväskylä, Department of Health Sciences, Jyväskylä, Finland, 2University of Oulu, Medical Research Center Oulu, Oulu, Finland, 3Fysios Oulu Kastelli, Oulu, Finland, 4Rokua Group, Mediterapia, Oulu, Finland, 5Central Hospital of Central Finland, Jyväskylä, Finland
Background: The effect of thoracic spine manipulation on thoracic spine symptoms and stiffness remains unknown.
Purpose: To evaluate the effect of thoracic spine manipulation on thoracic spine pain, disability and mobility in adult subjects.
Methods: Fifty-five subjects (40 females and 15 males) with mean age of 38 (range, 22-56) were recruited through local paper into the study. The subjects were randomized into thoracic manipulation (n=34) and sham-transcutaneous nervous stimulation (n=21) groups and they received maximum of six treatments in three weeks. Thoracic spine pain, disability and mobility were measured at baseline and post-treatments and the changes within three weeks were compared between groups with t-test and Mann Whitney U test. Primary outcomes were mean visual analog scale (VAS), maximum VAS and mean night VAS.
Results: Subjects had had thoracic spine pain for 32 weeks (range, 1-208) with mean VAS of 45mm (SD 18), maximum VAS of 56mm (SD 19) and mean night VAS of 42 (SD 24). Moreover, experienced state of health in VAS was 28mm (SD 18), Roland-Morris Disability Questionnaire (RMDQ) score was 5.1 (SD 3.2) and number of hypomobile thoracic spine segments in posterior to anterior (PA) pressure was 5.2 (SD 2.6). There were no differences between groups at baseline. The mean change in experienced state of health (9mm vs. -3mm, p=0.006), mean VAS (31mm vs. 13mm, p=0.01), maximum VAS (37mm vs. 11mm, p=0,001), mean night VAS (20mm vs. 1mm, p=0,027) and segmental thoracic PA pressure (3 vs. 1, p 0,001) were significantly higher in manipulation group. However, no differences between groups were found in RMDQ (2 vs. 0,5) although the trend was found in favor of manipulation group.
Conclusion(s): Thoracic spine manipulation can decrease experienced pain in the thoracic spine area in a short term. Moreover, thoracic spine mobility and experienced state of health improved as well.
Implications: Thoracic manipulation can be used in manual therapy practice to decrease the thoracic spine pain, hypomobility and, therefore, experienced state of health.
Funding acknowledgements: We acknowledge Juho Vainio Foundation, Finnish Association of Physiotherapist and Finnish Association of Orthopaedic Manual Therapy for providing funding.
Topic: Musculoskeletal: spine
Ethics approval: Ethical committee of Northern Ostrobothnia Hospital District reviewed the study protocol prior the study.
All authors, affiliations and abstracts have been published as submitted.
