The effects of different types of thoracic manual therapy for shoulder dysfunction: a systemic review with meta-analysis.

Study Summary

12 randomized controlled trials (RCTs) including 508 patients with shoulder dysfunction were included in this systematic review and meta-analysis comparing different thoracic manual therapy (TMT) techniques with sham treatment, conventional physiotherapy, or inactive physical modalities. Interventions included Maitland mobilization, high-velocity low-amplitude (HVLA) thrust manipulation, and Mulligan mobilization. Pooled outcomes of interest included shoulder pain, disability, and range of motion (ROM). Maitland mobilization significantly reduced pain and disability in patients with subacromial impingement syndrome (SIS), while HVLA manipulation did not demonstrate significant improvements in pain or disability. Mulligan mobilization showed promising benefits, although the evidence remained limited. Overall, Maitland mobilization appeared to be the most effective TMT technique for improving shoulder symptoms, suggesting that treatment selection should consider the specific manual therapy approach and shoulder condition.