Spencer's Technique for Shoulder Function

Overseen By Daniel Cawley, DC, MSHS, MS

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Edward Via Virginia College of Osteopathic Medicine

Disqualifiers: Shoulder surgery, Shoulder pain, Cervical radiculopathy, Connective tissue disorders, Diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

20 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

Is Spencer's Technique for shoulder function safe for humans?

The available research does not provide specific safety data for Spencer's Technique or its variations. Therefore, there is no relevant safety information available from the provided articles. ^{1 2 3 4 5}

How does Spencer's Technique for Shoulder Function differ from other treatments for shoulder conditions?

Spencer's Technique is unique because it involves a series of specific movements and muscle energy techniques designed to improve shoulder mobility and function, which is different from passive stretching or surgical interventions. This technique is often used for conditions like adhesive capsulitis (frozen shoulder) and focuses on active patient participation to enhance joint movement. ^{2 6 7 8 9}

What is the purpose of this trial?

The purpose of this study is to see the impact of a modified Spencer's technique on tissue stiffness, mobility, and blood flow of the shoulder joint. Spencer's technique is a well-known osteopathic manipulative treatment (OMT) that is common for treating adhesive capsulitis and is believed to help blood flow. There are studies that look at the clinical effects of the technique and/or compare it to other techniques; however, measuring the extent to which Spencer's technique, or this modified technique, improves tissue stiffness and blood flow has never been written in the literature. This study will serve as a proof of concept that this technique improves tissue stiffness, blood flow, and mobility of the shoulder join as well as the nearby areas. Using ultrasound, the investigators will measure tissue stiffness and blood flow and will analyze the mobility of the shoulder joint using a Vicon motion capture system.

Eligibility Criteria

This trial is for men and women aged 18-50 with healthy shoulders. It's not suitable for those who've had recent shoulder pain or surgery, nerve issues in the neck, muscle disorders, are pregnant or use tobacco. People with diabetes, prediabetes, or an allergy to ultrasound gel should also avoid this study.

Exclusion Criteria

I have had shoulder pain in my main throwing arm in the last 6 months.

Allergy to ultrasound gel (propylene glycol)

I have a disorder affecting my muscles or connective tissues.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

OMT Intervention

Participants receive osteopathic manipulative treatment (OMT) on the shoulder, followed by measurements of tissue stiffness, mobility, and blood flow

1 day

1 visit (in-person)

Rest and Measurement

Participants undergo a rest period and subsequent measurements on the shoulder to assess the effects of the OMT intervention

1 day

1 visit (in-person)

Follow-up

Participants are monitored for any changes in shoulder function and subjective stiffness after the intervention

1 day

1 visit (in-person)

Treatment Details

Interventions

• Spencer's Technique (Modified)

Trial Overview The study tests a modified Spencer's technique—an osteopathic treatment—on shoulder function. It measures how well it improves tissue stiffness, blood flow using ultrasound and mobility through motion capture technology.

Participant Groups

Group I: Rest, then OMT Intervention Experimental Treatment 2 Interventions

10 subjects will be randomized to begin with the non-dominant shoulder. Investigators will measure baseline outcomes on the non-dominant shoulder, a rest period equivalent to the time needed for OMT treatment, measure post treatment outcomes on non-dominant shoulder, a 5-minute rest period as a washout period, then proceed to measure baseline measures on dominant shoulder, provide OMT treatment, ending with post measurements on the dominant shoulder.

Group II: OMT Intervention, then Rest Experimental Treatment 2 Interventions

10 subjects will be randomized to begin with the dominant shoulder. Investigators will measure baseline outcomes on the dominant shoulder, apply OMT treatment, measure post treatment outcomes on dominant shoulder, a 5-minute rest period as a washout period, then proceed to measure baseline measures on non-dominant shoulder, a rest that is equivalent to the time needed for OMT treatment, ending with post measurements on the non-dominant shoulder.

Who Is Running the Clinical Trial?

Edward Via Virginia College of Osteopathic Medicine

Lead Sponsor

Trials

24

Recruited

2,700+

Findings from Research

The Spencer technique, developed over more than a century, is a comprehensive approach for diagnosing and treating shoulder issues, emphasizing the importance of adapting manipulative methods based on clinical needs.

Key developments in the technique include changes in the sequence of steps and the integration of muscle-energy methods, highlighting the role of anatomical and pathological understanding in improving treatment efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The evolution of osteopathic manipulative technique: the Spencer technique. Patriquin, DA.[2004]

The modified trapezius transfer technique, involving a folded tensor fascia lata graft, was successfully performed on 12 patients, resulting in significant improvements in shoulder abduction (mean increase of 116 degrees) and Disabilities of the Arm, Shoulder and Hand (DASH) scores after six months.

No major complications were reported, indicating that this technique is safe and can be easily adopted by surgeons for shoulder joint reconstruction in patients with brachial plexus injuries.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trapezius Transfer to Restore Shoulder Function in Traumatic Brachial Plexus Injury: Revisited and Modified. Karki, D., Muthukumar, V., Dash, S., et al.[2020]

Arthroscopic-assisted latissimus dorsi transfer (A-LDT) for massive rotator cuff tears was evaluated in 10 studies involving 348 patients, showing it has fewer surgical complications and less post-operative stiffness compared to traditional open techniques.

While A-LDT does not significantly improve clinical outcomes compared to open surgery, it may preserve deltoid muscle function, suggesting potential benefits for shoulder recovery, warranting further research with longer follow-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Arthroscopic-assisted latissimus dorsi transfer for massive rotator cuff tear: a systematic review. Osti, L., Buda, M., Andreotti, M., et al.[2019]

The trapezius muscle is crucial for shoulder function, and its loss can lead to significant mobility issues, including shoulder drooping and reduced arm abduction.

The modified Eden-Lange procedure, which transfers other muscles to restore trapezius function, shows promise for patients with trapezius paralysis who haven't responded to conservative treatments, but further long-term studies are needed to confirm its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tendon transfer for trapezius palsy. Werthel, JD., Masmejean, E., Elhassan, B.[2022]

In a study of seven patients with massive rotator cuff tears, the technique of superior capsular reconstruction (SCR) combined with partial cuff repair led to significant improvements in shoulder function and pain relief over 12 months, with average increases in Constant score (12.1 points) and UCLA score (9.4 points).

All patients demonstrated improved active forward flexion (average increase of 40 degrees) and a reduction in pain (average decrease of 5.1 points on the Numerical Pain Rating Scale), indicating that SCR can be an effective option even for complex cases of irreparable rotator cuff tears.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Salvaging the 'irreparable' tear: Superior Capsular Reconstruction augmented with partial cuff repair. Wong, SJ., Neo Jun Hao, B., Marian Lie, H., et al.[2023]

In a study of 60 patients with adhesive capsulitis (frozen shoulder), the Spencer muscle energy technique significantly improved pain, shoulder range of motion, and function compared to passive stretching after 4 weeks of treatment.

The trial demonstrated that the Spencer technique is a more effective intervention for managing symptoms of adhesive capsulitis than traditional passive stretching methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of Spencer muscle energy technique and Passive stretching in adhesive capsulitis: A single blind randomized control trial. Iqbal, M., Riaz, H., Ghous, M., et al.[2021]

In a study of 15 children with Erb's palsy, a minimally invasive arthroscopic release procedure significantly improved shoulder external rotation from an average of -24° to +46°, indicating enhanced shoulder function.

The procedure not only preserved internal rotation but also resulted in no recurrence of internal rotation contracture, with overall shoulder function improving as measured by the Mallet score from 11 to 17 points.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of functional outcomes and preliminary results in a case series of 15 children treated with arthroscopic release for internal rotation contracture of the shoulder joint after Erb's palsy. Elzohairy, MM., Salama, AM.[2020]

In a study of 24 patients with irreparable rotator cuff tears, the addition of middle trapezius tendon (MTT) transfer to in situ superior capsular reconstruction (SCR) significantly improved postoperative range of motion and functional outcomes compared to a standard 2-layer repair.

Patients who received the 3-layer tendon construct (MTT transfer-augmented) showed greater improvements in forward flexion (88.88° vs 46.66°) and external rotation (32.22° vs 16.0°), as well as better scores on the ASES and QuickDASH assessments, indicating enhanced effectiveness of the MTT transfer technique.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Middle Trapezius Tendon Transfer for Augmentation of In Situ Superior Capsular Reconstruction-Reinforced Partial Rotator Cuff Repair: Short-term Outcomes of a Prospective Cohort Study. Kandeel, AA.[2023]

Lower trapezius (LT) transfers have been shown to significantly improve shoulder function, including range of motion (ROM) and functional outcomes, in patients with massive irreparable rotator cuff tears, based on a systematic review of 18 studies.

Biomechanical studies indicate that LT transfers provide a larger moment arm for abduction and external rotation compared to latissimus dorsi transfers, suggesting they may be more effective for restoring shoulder function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The lower trapezius transfer: a systematic review of biomechanical data, techniques, and clinical outcomes. Clouette, J., Leroux, T., Shanmugaraj, A., et al.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

The evolution of osteopathic manipulative technique: the Spencer technique. [2004]

2. Singapore pubmed.ncbi.nlm.nih.gov

Trapezius Transfer to Restore Shoulder Function in Traumatic Brachial Plexus Injury: Revisited and Modified. [2020]

3. England pubmed.ncbi.nlm.nih.gov

Arthroscopic-assisted latissimus dorsi transfer for massive rotator cuff tear: a systematic review. [2019]

4. France pubmed.ncbi.nlm.nih.gov

Tendon transfer for trapezius palsy. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Salvaging the 'irreparable' tear: Superior Capsular Reconstruction augmented with partial cuff repair. [2023]

6. Pakistan pubmed.ncbi.nlm.nih.gov

Comparison of Spencer muscle energy technique and Passive stretching in adhesive capsulitis: A single blind randomized control trial. [2021]

7. England pubmed.ncbi.nlm.nih.gov

Evaluation of functional outcomes and preliminary results in a case series of 15 children treated with arthroscopic release for internal rotation contracture of the shoulder joint after Erb's palsy. [2020]

8. United States pubmed.ncbi.nlm.nih.gov

Middle Trapezius Tendon Transfer for Augmentation of In Situ Superior Capsular Reconstruction-Reinforced Partial Rotator Cuff Repair: Short-term Outcomes of a Prospective Cohort Study. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

The lower trapezius transfer: a systematic review of biomechanical data, techniques, and clinical outcomes. [2020]