Cervico-thoracic Manipulation to Treat Shoulder Pain

Clinical Prediction Rule

  • Pain-free shoulder flexion < 127°
  • Shoulder internal rotation < 53° at 90° of shoulder abduction
  • Negative Neer test
  • Not taking medication for shoulder pain
  • Symptoms < 90 days
0+
Variables Present

Positive Likelihood Ratio =

Probability of Success
78%
0+
Variables Present

Positive Likelihood Ratio =

Probability of Success
89%
0+
Variables Present

Positive Likelihood Ratio =

Probability of Success
100%

Neer Test

Diagnostic Accuracy when used alone:

Sensitivity
72%

Specificity
60%

Reference: Hegedus et al.

Evidence

Mintken PE, Cleland JA, Carpenter KJ, et al. Some factors predict successful short-term outcomes in individuals with shoulder pain receiving cervicothoracic manipulation: a single-arm trial. Phys Ther. 2010 Jan;90(1):26-42.

“This study successfully developed a set of prognostic factors that may help identify individuals with shoulder pain who are likely to experience meaningful changes in pain, disability, and ROM following cervicothoracic manipulation and general mobility exercises.”Mintken PE, Cleland JA, Carpenter KJ, et al.
No validation study currently published regarding this clinical prediction rule.
No impact analysis study currently published regarding this clinical prediction rule.