Effects of Thoracic Extension Versus Thoracic Stabilization Exercises in Patients With Maigne's Thoracic Pain

March 31, 2023 updated by: Riphah International University

Effects of Thoracic Extension Versus Thoracic Stabilization Exercises on Pain, Stiffness, Range of Motion, Disability and Posture in Patients With Maigne's Thoracic Pain.

The aim of this study is to compare the effects of thoracic extension versus thoracic stabilization exercises on pain, stiffness, range of motion, disability and posture in patients with Maigne's thoracic pain.This study will be a randomized clinical trial and 32 patients fulfilling the inclusion criteria will be included in the study. they will be allocated into 2 groups using non- probability purposive sampling technique. Group A will receive conventional treatment, myofascial release, thoracic spine mobilization with Thoracic Extension exercise program, while Group B will receive conventional treatment, myofascial release, thoracic spine mobilization with Thoracic Stabilization exercise program. Outcome measure: Numeric Pain Rating Scale, Goniometer, Thoracic Stiffness Index, Revised Oswestry Thoracic Pain Disability Questionnaire, standing thoracic X-ray and Flexi curve ruler, will measure pain, thoracic flexion and extension, Cobb's angle, kyphosis index, thoracic stiffness index and disability. Both groups will receive a total of 45 minutes session, thrice a week for 3 weeks. Measurements will be taken at the baseline, at the end of 3rd week and for long-term effects at the end of 6th week. Data will be analyzed by SPSS version 21.

Study Overview

Detailed Description

Maigne's thoracic pain is a condition in which pain originates from the thoracic spine, but according to Maigne, in most cases, its origin lies in the lower three cervical segments. It is common among both men and women, but it is most common among women. Common symptoms of Maigne's thoracic pain are tenderness and stiffness of thoracic muscles, especially interscapular muscles. The most important and chief complaint reported by patients of this condition is unilateral and severe pain which increases with static sitting and with carrying or lifting heavyweight. Physical examination of tenderness on the interscapular region at the level of T5-T6, 1-2 cm lateral to the midline. Pressure reproduces the patient's pain. Several clinical trials have established therapeutic guidelines and protocols for the rehabilitation of hyperkyphosis. These trials have typically focused on the use of spinal bracing, therapeutic taping, manual therapy, and therapeutic exercise for postural training. Studies have been conducted on the effectiveness of combination therapy of thoracic extension exercises with other therapeutic exercises. Similarly, many studies have been conducted on thoracic stabilization exercises for posture correction. It is quite difficult to judge which exercise is more effective than the other. Moreover, typically for the management of Maigne's Thoracic pain, the efficacy of therapeutic treatment is quite underexplored. The rationale of this study is that it will provide evidence that may improve treatment strategies for the management of Maigne's Thoracic pain, majorly focusing on the muscular component of the thoracic region.

Study Type

Interventional

Enrollment (Actual)

32

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Punjab
      • Lahore, Punjab, Pakistan
        • Riphah Rehabilitation Center, PSRD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years to 45 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients of age between 20-45 years
  • NPRS value more than or equal to 4
  • Cobb's Angle > 40°
  • Chronic Maigne's Thoracic pain

Exclusion Criteria:

  • Structural abnormalities
  • Neoplasm
  • Neurogenic problem
  • H/o cervical or thoracic surgery
  • H/o whiplash injury
  • Muscular strain
  • Lactating mothers
  • Pregnant or 6 months post-partum females

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group A
Thoracic extension exercises

Thoracic Extension Exercises (2 sets of 10 reps each/day). This exercise program will target thoracic spine extension and trunk muscle flexibility. A specialized program of thoracic extension in sitting, in prone lying, in quadruped position, on foam roller, wall angle stretch, corner stretch + hot pack (10 min) + Trapezius and Levator Scapulae stretching + Myofascial Release + Thoracic spinal mobilization (3 sets of 3 reps each/day). A total of 45 minutes session three times a week on alternate days for 3 weeks.

Assessment will be done at baseline, on the end of 3rd week and for long term effects at the end of 6th week.

Experimental: Group B
Thoracic Stabilization exercises
Thoracic Stabilization Exercises (2 sets of 10 reps each/day). This exercise program will target thoracic musculature, static and dynamic thoracic posture. A specialized program of Draw- in and chin tucks in crook lying, prone, sitting and standing, prone chin- tuck elevation exercises with arm at sides, arms behind head or overhead (4) + hot pack (10 min) + Trapezius and Levator Scapulae stretching + Myofascial Release + Thoracic spinal mobilization (3 sets of 3 reps each/day). A total of 45 minutes session three times a week on alternate days for 3 weeks. Assessment will be done at baseline, on the end of 3rd week and for long term effects at the end of 6th week.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
NPRS
Time Frame: 3rd Week
The NPRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0-10) that best reflects the intensity of his/her pain 11-point numeric scale ranges from '0' representing no pain to 10 representing the worst imaginable pain
3rd Week
Goniometer
Time Frame: 3rd Week
The science of measuring the joint ranges in each plane of the joint is called goniometry. Goniometer is a device that measures an angle or permits the rotation of an object to a definite position. Thoracic flexion and extension will be assessed through it.
3rd Week
Standing Thoracic X-ray
Time Frame: 3rd Week
One lateral view X-ray of each subject will be taken of the thoracic spine at the hospital radiography department. Subjects will stand in a relaxed position with arms elevated in front of them for the X-ray. Cobb's angle will be measured from X-ray.
3rd Week
Kyphosis Index (KI)
Time Frame: 3rd Week
Kyphosis Index will be measured using Flexi curve ruler, which is a flexible plastic 60-cm ruler to evaluate surface contour of thoracic curvature. The KI will be calculated by multiplying 100 by the value of thoracic width divided by thoracic length or KI = (thoracic width/length) ×100.
3rd Week
Thoracic Stiffness Index (TSI):
Time Frame: 3rd Week

The TSI will be calculated as the value of the:

KI in relaxed posture divided by the KI in best posture.

3rd Week
Revised Oswestry Thoracic Pain Disability Questionnaire (ROTPDQ)
Time Frame: 3rd Week
It is a self-reported measurement tool that measures both pain and functional status and is used for evaluating disability caused by thoracic pain.
3rd Week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 30, 2022

Primary Completion (Actual)

December 30, 2022

Study Completion (Actual)

January 30, 2023

Study Registration Dates

First Submitted

May 23, 2022

First Submitted That Met QC Criteria

May 23, 2022

First Posted (Actual)

May 27, 2022

Study Record Updates

Last Update Posted (Actual)

April 3, 2023

Last Update Submitted That Met QC Criteria

March 31, 2023

Last Verified

March 1, 2023

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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