Purpose: Identify individuals with shoulder pain who are likely to experience immediate improvement in pain and disability following cervical and thoracic spine manipulation.
Stage of CPR Development: Invalidated (Mintken et al., 2017)
1. Pain-free shoulder flexion < 127°
2. Shoulder internal rotation < 53° at 90° of abduction
3. Negative Neer test
4. Not taking medications for their shoulder pain
5. Symptoms less than 90 days
Derivation Study (Mintken et al., 2010):
|Variables||Sensitivity||Specificity||+LR||Prob of Success|
Validation Study (Mintken et al., 2017):
|Linear Mixed-Model with Repeated Measures||0.094|
|Positive on Rule MT+Ex v. Ex Only (SPADI)||0.69|
|3-way Interaction (SPADI)||0.27|
|3-way Interaction (Pain Score)||0.70|
|Repeated Measures Analyses (SPADI)||0.62|
|Repeated Measures Analyses (Pain Score)||0.87|
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.
2. Mintken PE, et al. Examination of the Validity of a Clinical Prediction Rule to Identify Patients With Shoulder Pain Likely to Benefit From Cervicothoracic Manipulation. J Orthop Sports Phys Ther. 2017; 47(4): 252-260. doi: 10.2519/jospt.2017.7100.