Purpose: Identify individuals with shoulder pain who are likely to experience immediate improvement in pain and disability following cervical and thoracic spine manipulation.
Rule:
1. Pain-free shoulder flexion less than ~125°
2. Shoulder internal rotation less than ~50° at 90° of abduction
3. Negative Neer’s test
4. Not taking medications for their shoulder pain
5. Symptoms less than 90 days
| Item |
2+ variable |
3+ variables |
4+ variables |
| SN |
0.90 |
0.51 |
0.27 |
| SP |
0.61 |
0.90 |
1.00 |
| +LR |
2.3 |
5.3 |
infinite |
| -LR | |||
| POS |
78% |
89% |
100% |
SN = sensitivity – ‘SnOut’ helps rule out a disease (higher number is better – >0.9 is excellent)
SP = Specificity – ‘SpIn’ helps rule in a disease (higher number is better – greater than 0.90 is excellent))
+LR = positive likelihood ratio – ratio of positive test results in a patients with the pathology (true positives) higher number is better (> 10 is excellent)
-LR = negative likelihood ratio – ratio of negative test results in a patients with the pathology (false negatives) lower number is better (< 0.1 is excellent)
POS = Probability of success – positive treatment outcome
References:
1. Mintken PE, et al. Some Factors Predict Successful Short-Term Outcomes in Individuals With Shoulder Pain Receiving Cervicothoracic Manipulation: A Single-Arm Trial. Phys Ther. 2010; 90(1): 26-42.
