Adding Manual Therapy to Shoulder Exercise: The One-Year Trial Results

Physical therapists and physical therapist assistants who treat outpatient shoulder pain and want a plain-language account of what this randomized trial reported about combining manual therapy with resistance exercise.

Physical therapists and physical therapist assistants in outpatient orthopedic, sports, and general musculoskeletal settings. Content is also relevant to athletic trainers and rehabilitation students following shoulder pain research.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports on a single peer-reviewed randomized clinical trial. All findings, figures, and conclusions described in the course come from that report; no outside data have been added.

Michener LA, McClure PW, Tate AR, Bailey LB, Seitz AL, Straub RK, Thigpen CA. Adding manual therapy to an exercise program improves long-term patient outcomes over exercise alone in patients with subacromial shoulder pain: a randomized clinical trial. JOSPT Open. 2024;2(1):29–48. Epub 11 December 2023. doi:10.2519/josptopen.2023.1134

Trial registration: ClinicalTrials.gov NCT00633451. Funded by the National Athletic Trainers’ Association — Research and Education Foundation, the Brooks Foundation, and the Thera-Band Academy. The authors reported no financial interests in the subject matter, and the funders had no role in study design, data collection, analysis, interpretation, or writing.

After completing this course, you will be able to:

1. Describe what the trial compared, in whom, and over what follow-up period, including how the exercise program and the added manual therapy were delivered.
2. State the direction and timing of the reported between-group findings for shoulder disability, satisfaction with shoulder use, perceived global change, and additional health care use.
3. Explain the limits the authors placed on their own findings, including the absence of short-term separation, the small magnitude of the differences, and the standardized rather than individualized treatment.

1. Start Here: How This Course Works
2. The Podcast: Manual Therapy Added to Shoulder Exercise (about nine minutes)
3. Subacromial Shoulder Pain and the Unsettled Manual Therapy Question
4. How the Trial Was Run: Two Standardized Treatment Programs
5. What Changed, and When: Results Through One Year
6. Where the Findings Are Loose: Limits the Authors Named
7. What This Could Mean in the Clinic
8. Key Takeaways
9. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course reports on a single peer-reviewed randomized clinical trial. All findings, figures, and conclusions described in the course come from that report; no outside data have been added.
2. Michener LA, McClure PW, Tate AR, Bailey LB, Seitz AL, Straub RK, Thigpen CA. Adding manual therapy to an exercise program improves long-term patient outcomes over exercise alone in patients with subacromial shoulder pain: a randomized clinical trial. JOSPT Open. 2024;2(1):29–48. Epub 11 December 2023. doi:10.2519/josptopen.2023.1134
3. Trial registration: ClinicalTrials.gov NCT00633451. Funded by the National Athletic Trainers' Association — Research and Education Foundation, the Brooks Foundation, and the Thera-Band Academy. The authors reported no financial interests in the subject matter, and the funders had no role in study design, data collection, analysis, interpretation, or writing.