Evidence map›Paper›PMID 34571486›Full record

ArticleClinical biomechanics (Bristol, Avon)2021

Evidence for increased neuromuscular drive following spinal manipulation in individuals with subacromial pain syndrome.

Amy K Hegarty, Melody Hsu, Jean-Sébastien Roy, Joseph R Kardouni, Jason J Kutch, Lori A Michener

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical biomechanics (Bristol, Avon), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06110039 (Comparative Effects of Cervicothoracic Junction Mobilization With Arm Movements and Upper Thoracic Manipulation in Patients With Subachromial Impinegment Syndrome), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT06110039 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Comparative Effects of Cervicothoracic Junction Mobilization With Arm Movements and Upper Thoracic Manipulation in Patients With Subachromial Impinegment Syndrome

TypeinterventionalSponsorRiphah International UniversityRan2023 to 2024Enrolled30ConditionsSubacromial Impingement SyndromeArmsCervicothoracic Junction Mobilization, Upper Thoracic Spine Manipulation:
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Relationship between changes in neuromuscular factors and disability outcomes following a resistance exercise intervention in rotator cuff tendinopathy.Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology · 2025
    Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Amy K HegartyDivision of Biokinesiology and Physical Therapy, University of Southern California, 1540 E. Alcazar Street, CHP155, Los Angeles, CA 90089; USA. Electronic address: amyhegar@pt.usc.edu.
Melody HsuJohns Hopkins University, Baltimore, MD, USA. Electronic address: mhsu13@jhu.edu.
Jean-Sébastien RoyFaculty of Medicine, Department of Rehabilitation, Laval University; Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada. Electronic address: Jean-Sebastien.Roy@fmed.ulaval.ca.
Joseph R KardouniFORSCOM Holistic Health and Fitness (H2F) Field Test, U.S. Army Forces Command, Fort Bragg, NC, USA.
Jason J KutchDivision of Biokinesiology and Physical Therapy, University of Southern California, 1540 E. Alcazar Street, CHP155, Los Angeles, CA 90089; USA. Electronic address: kutch@usc.edu.
Lori A MichenerDivision of Biokinesiology and Physical Therapy, University of Southern California, 1540 E. Alcazar Street, CHP155, Los Angeles, CA 90089; USA. Electronic address: lmichene@usc.edu.

Funding

Center for Clinical and Translational ResearchUL1TR000058 · NCATS · VIRGINIA COMMONWEALTH UNIVERSITY · PI MOELLER, FREDERICK GERARD · 2012 to 2015
$12.5M
Motor cortical neuromodulation in women with Interstitial Cystitis/Bladder Pain Syndrome: reducing pain by improving brain and muscle activityR01DK121724 · NIDDK · UNIVERSITY OF SOUTHERN CALIFORNIA · PI KUTCH, JASON J., RODRIGUEZ, LARISSA · 2020 to 2024
$2.4M
Sensorimotor impairments in men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: relationship of resting state brain activity to pelvic floor muscle activationR01DK110669 · NIDDK · UNIVERSITY OF SOUTHERN CALIFORNIA · PI KUTCH, JASON J. · 2017 to 2020
$1.3M
NCATS NIH HHS UL1 TR000058NIDDK NIH HHS R01 DK110669NIDDK NIH HHS R01 DK121724
6 · The paper itself

Abstract

backgroundThoracic spinal manipulation can improve pain and function in individuals with shoulder pain; however, the mechanisms underlying these benefits remain unclear. Here, we evaluated the effects of thoracic spinal manipulation on muscle activity, as alteration in muscle activity is a key impairment for those with shoulder pain. We also evaluated the relationship between changes in muscle activity and clinical outcomes, to characterize the meaningful context of a change in neuromuscular drive.

methodsParticipants with shoulder pain related to subacromial pain syndrome (n = 28) received thoracic manipulation of low amplitude high velocity thrusts to the lower, middle and upper thoracic spine. Electromyographic muscle activity (trapezius-upper, middle, lower; serratus anterior; deltoid; infraspinatus) and shoulder pain (11-point scale) was collected pre and post-manipulation during arm elevation, and normalized to a reference contraction. Clinical benefits were assessed using the Pennsylvania Shoulder Score (Penn) at baseline and 2-3 days post-intervention.

findingsA significant increase in muscle activity was observed during arm ascent (p = 0.002). Using backward stepwise regression analysis, a specific increase in the serratus anterior muscle activity during arm elevation explained improved Penn scores following post-manipulation (p < 0.05).

interpretationThoracic spinal manipulation immediately increases neuromuscular drive. In addition, increased serratus anterior muscle activity, a key muscle for scapular motion, is associated with short-term improvements in shoulder clinical outcomes.

Indexed as

Manipulation, SpinalShoulder Impingement SyndromeSuperficial Back MusclesBiomechanical PhenomenaElectromyographyHumansMuscle, SkeletalScapulaShoulder PainElectromyographyPersistent painShoulderShoulder painSpinal manipulationSubacromial impingement

Identifiers

PMID34571486
PMCPMC8793937

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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.