ArticleThe Journal of manual & manipulative therapy2015
Regional interdependence and manual therapy directed at the thoracic spine.
Article in The Journal of manual & manipulative therapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Spinal Manipulation on Hip Extension Strength and Jump Height, A Double Blind Randomized Control Trial
Comparative Effects of Cervicothoracic Junction Mobilization With Arm Movements and Upper Thoracic Manipulation in Patients With Subachromial Impinegment Syndrome
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Impact of audible pops associated with spinal manipulation on perceived pain: a systematic review.Chiropractic & manual therapies · 2022Pooled it
- Effectiveness of cervicothoracic and thoracic manual physical therapy in managing upper quarter disorders - a systematic review.The Journal of manual & manipulative therapy · 2022Pooled it
- The importance of selecting the correct site to apply spinal manipulation when treating spinal pain: Myth or reality? A systematic review.Scientific reports · 2021Pooled it
- The Effects of Thoracic Flexibility Exercise on Pain, Range of Motion, Spinal Alignment, Proprioception, and Neck Disability Index in Neck Pain Patients with Forward Head Posture: A Randomized Controlled Trial.Medicina (Kaunas, Lithuania) · 2026Trial
- The Effects of Spinal Manipulation Added to Exercise on Pain and Quality of Life in Patients with Thoracic Spinal Pain: A Randomized Controlled Trial.BioMed research international · 2023Trial
- Thoracic spine thrust manipulation for individuals with cervicogenic headache: a crossover randomized clinical trial.The Journal of manual & manipulative therapy · 2022Trial
- The effect of manual therapy to the thoracic spine on pain-free grip and sympathetic activity in patients with lateral epicondylalgia humeri. A randomized, sample sized planned, placebo-controlled, patient-blinded monocentric trial.BMC musculoskeletal disorders · 2020Trial
- Knowledge and use of thoracic manipulations by manual therapists in Belgium and the Netherlands.The Journal of manual & manipulative therapy · 2026Article
- Rest Before Physical Therapy Is Not Necessary to Achieve Bony Healing of Lumbar Spondylolysis in Adolescent Athletes.Orthopaedic journal of sports medicine · 2026Article
- The 2023 patient profile and clinical management characteristics at a South African chiropractic training clinic: a descriptive cross-sectional study.Chiropractic & manual therapies · 2026Article
- Effectiveness of Thoracic Spine Manipulation for the Management of Neck Pain: A Systematic Umbrella Review with Risk of Bias and Methodological and Reporting Quality.Healthcare (Basel, Switzerland) · 2026Review
- Manual Therapy in Conjunction With Other Multimodal Interventions in a Patient With Chronic Pain and Hypertension: A Case Report.Clinical case reports · 2025Article
- Manual therapy considerations for adhesive capsulitis in the breast cancer population: a clinical perspective.The Journal of manual & manipulative therapy · 2025Article
- Pain and Disability Reduction Following Rib Manipulation in a Patient Recovering from Osteomyelitis of the Thoracic Spine.Healthcare (Basel, Switzerland) · 2025Article
- Reliability and Validity of Visual Estimation in Determining Thorax Rotation Mobility using the Quadruped Lumbar-Locked Position.International journal of sports physical therapy · 2024Article
- The Effect of Upper Cervical Mobilization/Manipulation on Temporomandibular Joint Pain, Maximal Mouth Opening, and Pressure Pain Thresholds: A Systematic Review and Meta-Analysis.Archives of rehabilitation research and clinical translation · 2023Review
- Physical Therapy Interventions for the Management of Biceps Tendinopathy: An International Delphi Study.International journal of sports physical therapy · 2022Article
- The Effect of High Velocity Low Amplitude Cervical Manipulations on the Musculoskeletal System: Literature Review.Cureus · 2020Review
- Spinal manipulation after multiple fusions in an adult with scoliosis: a case report.The Journal of manual & manipulative therapy · 2019Article
- A pragmatic regional interdependence approach to primary frozen shoulder: a retrospective case series.The Journal of manual & manipulative therapy · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Thoracic spine manipulation is commonly used by physical therapists for the management of patients with upper quarter pain syndromes. The theoretical construct for using thoracic manipulation for upper quarter conditions is a mainstay of a regional interdependence (RI) approach. The RI concept is likely much more complex and is perhaps driven by a neurophysiological response including those related to peripheral, spinal cord and supraspinal mechanisms. Recent evidence suggests that thoracic spine manipulation results in neurophysiological changes, which may lead to improved pain and outcomes in individuals with musculoskeletal disorders. The intent of this narrative review is to describe the research supporting the RI concept and its application to the treatment of individuals with neck and/or shoulder pain. Treatment utilizing both thrust and non-thrust thoracic manipulation has been shown to result in improvements in pain, range of motion and disability in patients with upper quarter conditions. Research has yet to determine optimal dosage, techniques or patient populations to which the RI approach should be applied; however, emerging evidence supporting a neurophysiological effect for thoracic spine manipulation may negate the need to fully answer this question. Certainly, there is a need for further research examining both the clinical efficacy and effectiveness of manual therapy interventions utilized in the RI model as well as the neurophysiological effects resulting from this intervention.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.