Study Summary

Ten randomized controlled trials including 444 participants with subacromial impingement syndrome (SIS) were included in this systematic review and meta-analysis comparing thoracic spine manual therapy (TSMT) either alone or combined with exercise versus placebo or exercise-only physiotherapy. Pooled outcomes of interest included pain intensity (VAS or NPRS), disability (SPADI or DASH), and shoulder range of motion (ROM) (flexion, abduction, internal rotation, and external rotation). The pooled analysis demonstrated that TSMT significantly reduced pain at short-term and intermediate-term follow-up and improved disability outcomes, while also improving some shoulder ROM measures such as internal and external rotation. Overall, these findings suggest that TSMT is an effective conservative intervention for improving pain, disability, and certain movement outcomes in individuals with SIS, particularly in the short term.