title: Scapulothoracic Muscle Strength Changes Following a Single Session of Manual Therapy and an Exercise Programme in Subjects with Neck Pain.
abstract: Scapulothoracic muscle weakness has been associated with neck pain (NP). Little evidence exists regarding lower trapezius (LT), middle trapezius (MT) and serratus anterior (SA) strength in this population. LT strength changes have been observed following thoracic manipulation in healthy subjects. The purpose of the present study was to examine scapulothoracic strength changes following cervical manipulation in subjects with NP.
  
  
  
  Twenty-two subjects with NP and 17 asymptomatic control (AC) subjects underwent strength testing of the LT, MT and SA using a hand-held dynamometer. Subjects with NP were treated with passive intervertebral neck manipulation and neck range of motion exercises. The AC group received no intervention. Strength testing was repeated after manipulation, then 48 and 96 hours later. Change scores were calculated for strength over time. Paired t-tests were done for strength change between painful and non-painful sides in the NP group. Independent t-tests were done for strength change between the NP group and AC group.
  
  
  
  There was no significant difference between groups for age, gender, hand dominance or body mass index. Mean (standard deviation) symptom duration for subjects in the NP group was 43.27 (62.71) months. There was no significant difference in strength change over time between painful and non-painful sides in the NP group for any muscle; however, there was a significant difference in strength change over time between those in the NP group and AC group for the LT (p < 0.01), SA (p < 0.01) and MT (p < 0.01).
  
  
  
  Scapulothoracic muscle strength improvements were observed in both extremities following passive intervertebral neck manipulation and neck range of motion exercises. Improvements lasted up to 96 hours following manipulation, even though no strengthening exercises were prescribed.
  
  
  
  Manipulation and range of motion should be considered as a component of intervention programmes for patients with NP and scapulothoracic muscle weakness. Future studies should compare manipulation alone to exercise alone to determine impact on strength. Copyright © 2016 The Authors Musculoskeletal Care Published by John Wiley & Sons Ltd.
authors.affiliation: Des Moines University, Des Moines, IA, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Petersen
authors.affiliation: Des Moines University, Des Moines, IA, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Domino
authors.affiliation: Des Moines University, Des Moines, IA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Postma
authors.affiliation: Des Moines University, Des Moines, IA, USA.
authors.forename: Cody
authors.initials: C
authors.lastname: Wells
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Cook
mesh_terms: D000328:Adult; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D026201:Musculoskeletal Manipulations; D019547:Neck Pain / Q000628:therapy*; D064171:Superficial Back Muscles / Q000502:physiology*; D055815:Young Adult
keywords: Axioscapular; manipulation; mobilization; scapula; serratus anterior; trapezius