Evidence-Based Upper Extremity Thrust Manipulation

Evidence Summary Table
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Author (Year) Level of Evidence Pathology Upper Extremity Manipulation(s) Performed
Struijs et al. (2003)[1] 1b Lateral Epicondylitis
  • Wrist manipulated from neutral position to maximal extension
Nagrale et al. (2009)[2] 1b Lateral Epicondylitis
  • Mill's manipulation
Goyal et al. (2013)[3] 1b Lateral Epicondylitis
  • Wrist manipulation (Scaphoid)
Kearns et al. (2012)[4] 4 Cubital Tunnel Syndrome
  • Lateral thrust manipulation of humeral ulnar joint
  • Palmar thrust manipulation of triquetrum on hamate
Sucher BM (1994)[5] 1b
 Carpal Tunnel Syndrome
  • Opponens roll
Siu et al. (2012)[6] 5
 Carpal Tunnel Syndrome
  • Opponens roll
  • Carpal bone HVLA
  • Metacarophalangeal joint HVLA
  • Carpometacarpal joint HVLA
  • Posterior radial head HVLA



Lateral Epicondylitis
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Struijs et al. (2003)
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  • Manipulation Performed

+ Wrist manipulated from neutral position to maximal extension

  • Results

+ Following 3 weeks of treatment

- 62% of thrust manipulation patients reported being "much improved or "completely improved"

- Only 20% of the control group achieved these outcomes


Nagral et al. (2009)[edit | edit source]

  • Treatment

+ Cyriax physiotherapy (deep tendon massage + Mill's manipulation) vs. Phonophoresis

  • Results

+ Following 4 weeks of treatment

- 26% increase in function on the Tennis Elbow Function Scale


Goyal et al. (2013)
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Cubital Tunnel Syndrome[edit | edit source]

Kearns et al. (2012)[edit | edit source]

Carpal Tunnel Syndrome[edit | edit source]

Sucher BM (1994)[edit | edit source]

Siu et al. (2012)[edit | edit source]

References
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1. Struijs P, Damen PJ, Bakker E, Blankevoort L, Assendelft W, Dijk CN. Manipulation of the Wrist for Management of Lateral Epicondylitis: A Randomized Pilot Study. Phys Ther 2003; 83(7):608-616.

2. Nagrale AV, Herd CR, Ganvir S, Remteke G. Cyriax physiotherapy versus phonophoresis with supervised exercises in subjects with lateral epicondylagia: a randomized clinical trial. J Man Manip Ther. 2009; 17(3): 171-8.

3. Goyal M, Kumar A, Monga M, Moitra M. Effect of Wrist Manipulation & Cyriax Physiotherapy Training on Pain & Grip Strength in Lateral Epicondylitis Patients. J Ex Sci Physiother. 2003; 9(1): 17-22.

4. Kearns G, Sharon W. Medical diagnosis of cubital tunnel syndrome ameliorated with thrust manipulation of the elbow and carpals. J Man Manip Ther. 2012; 20(2): 90-95.

5. Sucher BM. Palpatory diagnosis and manipulative management of carpal tunnel syndrome. J Am Osteopath Assoc. 1994; 94(8): 647-63.

6. Siu G, Jaffe JD, Rafique M, Weinik MM. Osteopathic Manipulative Medicine for Carpal Tunnel Syndrome. J Am Osteopath Assoc. 2012; 112(3): 127-139.

  1. ↑ Struijs P, Damen PJ, Bakker E, Blankevoort L, Assendelft W, Dijk CN. Manipulation of the Wrist for Management of Lateral Epicondylitis: A Randomized Pilot Study. Phys Ther 2003; 83:608-616.
  2. ↑ Nagrale AV, Herd CR, Ganvir S, Remteke G. Cyriax physiotherapy versus phonophoresis with supervised exercises in subjects with lateral epicondylagia: a randomized clinical trial. J Man Manip Ther. 2009; 17(3): 171-8.
  3. ↑ Goyal M, Kumar A, Monga M, Moitra M. Effect of Wrist Manipulation & Cyriax Physiotherapy Training on Pain & Grip Strength in Lateral Epicondylitis Patients. J Ex Sci Physiother. 2003; 9(1): 17-22.
  4. ↑ Kearns G, Sharon W. Medical diagnosis of cubital tunnel syndrome ameliorated with thrust manipulation of the elbow and carpals. J Man Manip Ther. 2012; 20(2): 90-95.
  5. ↑ Sucher BM. Palpatory diagnosis and manipulative management of carpal tunnel syndrome. J Am Osteopath Assoc. 1994; 94(8): 647-63.
  6. ↑ Siu G, Jaffe JD, Rafique M, Weinik MM. Osteopathic Manipulative Medicine for Carpal Tunnel Syndrome. J Am Osteopath Assoc. 2012; 112(3): 127-139.
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