Adding Thoracic SNAGS Improves Pain and Function in Shoulder Impingement
Efficacy of Mulligan thoracic sustained natural apophyseal glides on sub-acromial pain in patients with sub-acromial impingement syndrome: a single-blinded randomized controlled trial.
J Man Manip Ther . 2024 Dec;32(6):584-593.Seventy-four patients with unilateral sub-acromial impingement syndrome (SAIS), were randomized to thoracic sustained natural apophyseal glides (SNAGS) plus supervised exercise (n=37) or supervised exercise alone (n=37). The primary outcome was sub-acromial space (acromiohumeral distance on AP radiograph). Secondary outcomes were pain (VAS), SPADI, and shoulder ROM (flexion, abduction, internal/external rotation). Outcomes were measured at baseline and 4 weeks. Overall, the results revealed significantly greater post-treatment gains with SNAGS for the primary outcome and for all secondary outcomes. These findings suggest that brief, adjunctive thoracic SNAGS meaningfully augments standard exercise in short-term management of SAIS.
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