Manual Physical Therapy for Injection-Confirmed Nonacute Acromioclavicular Joint Pain

Orthopaedic Manual Physical Therapy for Shoulder Pain and Impaired Movement in a Patient With Glenohumeral Joint Osteoarthritis: A Case Report

“…In a cohort study of patients with acromioclavicular joint pain, patients received up to 4 booster treatment sessions at a 4-month follow-up, and improvements in pain and function were maintained at 6 months. 21 A recent large, multicenter randomized controlled trial of patients with hip and knee OA also utilized 2 booster sessions at a 4-month follow-up.…”

“…4,19,28 An orthopaedic manual physical therapy approach, which combines manual physical therapy and reinforcing exercise tailored to the individual patient, has been shown to decrease pain and improve function in patients with subacromial impingement syndrome, atraumatic rotator cuff tears, and primary acromioclavicular joint pain. 4,5,21,24,29,43 In a recent pragmatic randomized controlled trial, patients with unilateral subacromial impingement syndrome, treated with either manual physical therapy or a corticosteroid injection, demonstrated significant improvements in pain and function that persisted at 1 year. 43 To our knowledge, peer-reviewed evidence supporting physical therapy intervention in the management of GHJ OA is absent.…”

“…Examination and treatment techniques were originally defined by Maitland and Mulligan and have been more recently described in the peer-reviewed literature. 14,21,43,44 Home exercises consisted of range-of-motion, stretching, and strengthening exercises.…”

“…Recent studies of manual physical therapy interventions have found that booster treatments may prolong the beneficial effects of physical therapy, especially in patients with chronic and/or degenerative conditions. 1, 21 After an abbreviated patient interview and physical examination, selection of manual physical therapy treatment techniques and exercises began with those that proved to be the most beneficial during the earlier course of treatment. The intensity and dosage of each manual therapy technique and exercise were progressed in the manner described earlier.…”

Manual physical therapy combined with high-intensity functional rehabilitation for severe lower extremity musculoskeletal injuries: a case series

“…One manual therapy treatment 'dose' was defined as three sets of a 30-second mobilization, one thrust manipulation, or 3 minutes of soft-tissue mobilization. 38 All treatments performed in this study were grade III or IV mobilizations, as described by Maitland, into the resistance of passive accessory or physiologic joint motion or grade V thrust manipulations. 26 Grade V thrust manipulations were frequently performed at the talocrural, distal tib-fib, midfoot, and forefoot …”