Cervical and Shoulder Manipulative Therapy Effects on Pain Sensitivity

MISSING IMAGE

Material Information

Title:
Cervical and Shoulder Manipulative Therapy Effects on Pain Sensitivity
Physical Description:
1 online resource (118 p.)
Language:
english
Creator:
Coronado, Rogelio A
Publisher:
University of Florida
Place of Publication:
Gainesville, Fla.
Publication Date:

Thesis/Dissertation Information

Degree:
Doctorate ( Ph.D.)
Degree Grantor:
University of Florida
Degree Disciplines:
Rehabilitation Science
Committee Chair:
GEORGE,STEVEN
Committee Co-Chair:
ROBINSON,MIKE E
Committee Members:
BISHOP,MARK DONALD
BIALOSKY,JOEL ERIC
RILEY,JOSEPH LEO
MITCHENER,LORI

Subjects

Subjects / Keywords:
manipulation -- musculoskeletal -- pain -- shoulder -- therapy
Rehabilitation Science -- Dissertations, Academic -- UF
Genre:
Rehabilitation Science thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract:
Manipulative therapy is commonly used in the management of individuals with musculoskeletal pain. Spinal manipulative techniques, such as cervical manipulative therapy, are at times included in a management approach where the technique is targeted to a non-painful region remote to the individual's primary pain complaint (i.e. shoulder pain). While the underlying mechanisms of manipulative therapy are yet to be fully understood, laboratory-based studies indicate manipulative therapy has an influence on central pain processes, supporting application of techniques to the non-painful spine region for treatment of extremity conditions. Despite this potential, direct comparison of spinal and extremity-directed interventions on pain processing have not been widely examined. In this study, we examined the immediate and short-term effects of cervical and shoulder manipulative therapy on pain processing in patients with unilateral shoulder pain. Data were assessed from 74 clinical participants with shoulder pain randomly assigned to receive cervical (n = 25) or shoulder (n = 27) manipulative therapy or standard shoulder exercises (n = 22). We also assessed data from 25 age- and sex-matched, healthy participants to determine the presence of altered sensitization in the clinical participants. Our primary outcomes were immediate changes in pain processing occurring over a 2-week period. Pain processing was measured by pressure (PPT) and heat pain threshold (HPT) and suprathreshold heat pain response (SHPR). We also obtained short-term clinical outcomes for pain intensity and disability at 4 weeks to assess the relationship between within-session pain processing effects and longer-term clinical outcome. Clinical participants demonstrated enhanced sensitivity at areas local and remote to the shoulder for PPT and at a remote region for HPT suggesting peripheral and central sensitization. Favorable effects on these indirect measures of sensitization were observed immediately following therapeutic intervention (p 0.05). Reductions in clinical pain and disability were also observed at the 4-week follow-up time point (p 0.05), We did not find an association between immediate changes in pain processing over a 2-week period and 4-week clinical outcome (p > 0.05). These results suggest that cervical manipulative therapy and shoulder-directed intervention (manipulative therapy or exercise) result in similar within-session pain processing and between-session clinical effects. The lack of association between these pain processing effects and clinical outcome may suggest other underlying pathways for clinical benefit.
General Note:
In the series University of Florida Digital Collections.
General Note:
Includes vita.
Bibliography:
Includes bibliographical references.
Source of Description:
Description based on online resource; title from PDF title page.
Source of Description:
This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility:
by Rogelio A Coronado.
Thesis:
Thesis (Ph.D.)--University of Florida, 2014.
Local:
Adviser: GEORGE,STEVEN.
Local:
Co-adviser: ROBINSON,MIKE E.
Electronic Access:
RESTRICTED TO UF STUDENTS, STAFF, FACULTY, AND ON-CAMPUS USE UNTIL 2015-05-31

Record Information

Source Institution:
UFRGP
Rights Management:
Applicable rights reserved.
Classification:
lcc - LD1780 2014
System ID:
UFE0046471:00001