Cervical Spine Screening Based on Movement Strategies Improves Shoulder Physical Variables in Neck-Related Shoulder...

Background: It is important to consider the cervical spine as a potential contributor to shoulder pain, indicating the paramount importance of screening the cervical spine in patients with shoulder pain. Objectives: To study the immediate effects of cervical spine screening (CSS) on the shoulder active range of motion, isometric strength and self-reported function in patients with neck-related shoulder pain. Methods: A secondary analysis was conducted on data from a previous study. A cervical contribution was considered if a ≥30% shoulder symptom modification of pain intensity (Numeric Pain Rating Scales) was recorded during the most painful shoulder movement after CSS. Pre-post measurements of the shoulder active range of motion (inclinometer) and shoulder isometric strength (dynamometer) were recorded in a single session. Self-reported shoulder function (Shoulder Pain and Disability Index) was assessed at a 1-week follow-up. Results: Among 60 participants, statistically significant changes were found for those with a cervical contribution (n = 30) for shoulder flexion and the abduction range of motion (p < 0.001), with a medium size effect (r = 0.55), and in internal rotation (p = 0.02) and external rotation at 0° abduction (p = 0.008), with a small size effect (r = 0.3 and 0.34, respectively). The self-reported shoulder function in those without a cervical contribution significantly declined from the pre to post measurements (p = 0.002), with a small size effect (r = 0.4). No statistically significant changes were found for the isometric strength in either group. Conclusions: In patients with shoulder pain classified as having a cervical contribution, CSS produces intrasession improvements in the active shoulder range of motion but not in the shoulder isometric strength or self-reported shoulder function.