Shoulder PainNCT07064772
The Immediate Effects of First Rib Mobilization on Pain and Range of Motion in Patients With Shoulder Pain
A study testing First Rib Mobilization in people with Shoulder Pain, run by Andrews University at 1 site in United States.
Trial summary
The purpose of this clinical trial is to examine whether one session of a specific manual physical therapy technique, known as first rib mobilization, can lead to immediate improvements in pain and movement in individuals with shoulder pain. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Shoulder Pain
- What is being tested?
- First Rib Mobilization
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 64 participants
- Where
- 1 siteUnited States
- Study dates
- 14 Jul 2025to 30 Jul 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Men and Women
- Ages 18-75 years old
- Attending physical therapy
- Primary complaint of shoulder pain
- Pain intensity >3/10 on the Numeric Pain Rating Scale (NPRS)
- A Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick DASH) score greater than 16% impaired
Who cannot join
- Previous shoulder or neck surgery
- Clinical signs of a full rotator cuff tear (positive drop arm test)
- Having positive MRI findings of a complete rotator cuff tear
- Having a positive Spurling's test
- Having a steroid injection in the cervical spine and/or shoulder in the last two months
- Having any red flags (history of cancer, upper motor neuron disorder, fractures, osteoporosis, acute inflammatory process)
- Expressing fear/anxiety related to receiving manual therapy treatment
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site
Lebanon Valley College
Annville, Pennsylvania, 17003
Michael L Fink, Doctor of Science, 717-867-6847, fink@lvc.edu
Joseph R Hribick, Doctor of Physical Therapy, 717-538-0786, hribick@andrews.edu
About this study
The purpose of this clinical trial is to examine whether one session of a specific manual physical therapy technique, known as first rib mobilization, can lead to immediate improvements in pain and movement in individuals with shoulder pain. We hypothesize that this single treatment will result in reduced pain and increased ability to move the shoulder and neck. Researchers will compare first rib mobilization to a sham mobilization (a look-alike hands-on position that does not mobilize the first rib) to see if first rib mobilization works to immediately reduce pain and improve movement in patients with shoulder pain.
Participants will receive first rib mobilization or a sham mobilization during a single session of physical therapy and will receive pre and post intervention measurements of their pain levels and neck and shoulder range of motion.
- Conditions
- Shoulder Pain
- Being tested
- First Rib Mobilization, Sham Comparator
- Keywords
- Manual Therapy, Physical Therapy, First Rib, Joint Mobilization, Shoulder Pain
- Medical subject headings
- Shoulder Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
First Rib MobilizationOther
Participants in the mobilization group will receive either a seated or supine three stage progressive muscle energy technique (MET) plus a singular high-velocity, low-amplitude thrust (HVLAT) mobilization technique directed to their first rib on their symptomatic side based on the discretion of the treating physical therapist.
Sham ComparatorOther
Participants in the sham mobilization (control) group will be placed in a supine, hook-lying position identical to the mobilization group; however, they will be instructed to inhale and exhale 3 times using diaphragmatic breathing (avoiding upper chest recruitment) as the physical therapist gently rests his or her hand over the area of the upper trapezius muscle just proximal to the first rib to simulate a sham mobilization hand placement. Therefore, physical therapists will not use any significant compressive force to the musculature, perform any tactile cueing for upper chest breathing, perform any mobilizations, nor perform any HVLAT techniques to participants in the sham mobilization group.
| Study group | Role | What they receive |
|---|---|---|
| First Rib Mobilization Group | Experimental | Participants in this arm will be randomly assigned to receive a first rib mobilization on their affected side of shoulder pain by a licensed physical therapist. Receives: Other: First Rib Mobilization |
| Sham Mobilization | Sham comparator | Participants in this arm will be randomly assigned to receive a sham mobilization to the region of the first rib on their affected side of shoulder pain by a licensed physical therapist. Receives: Other: Sham Comparator |
What is being measured
The primary outcome is the main question the study is designed to answer.
Range of motion
Cervical and Shoulder active range of motion
Measured: Cervical and shoulder active range of motion will be assessed in participants in both groups at baseline and immediately following the intervention
Pain Intensity
Pain Intensity will be assessed via the Numeric Pain Rating Scale (NPRS). On this scale, zero is equivalent to no pain and 10 indicates the worst possible pain.
Measured: Change in pain intensity from baseline to immediately following intervention in both groups
Secondary outcomes (1)
Global Rating of Change
The GROC is a single-item measure that captures a patient's perceived change in their condition over time. It uses a 15-point scale ranging from -7 ("a very great deal worse") to +7 ("a very great deal better"), with 0 indicating "no change."
Measured: This will be administered to participants in both groups immediately after intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Jul 2025
- Study start14 Jul 2025 (estimated)
- Primary completion30 Jul 2026 (estimated)
- Study completion30 Jul 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Shoulder PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 64 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Andrews University
- Sponsor type
- University, hospital or other
- Collaborators
- Lebanon Valley College
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07064772
- Sponsor's protocol ID
- 25-095
- Status last verified
- Jul 2025
- First submitted
- 7 Jul 2025
- Last updated
- 15 Jul 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Individual Participant Data (IPD) Sharing Statement Plan to Share IPD: Yes Description: Deidentified individual participant data (IPD) that underlie the results of this study will be shared. Time Frame: Data will be available beginning 3 months following publication and will remain available for 5 years. Access Criteria: Access will be granted to qualified researchers with a methodologically sound proposal, subject to approval by the study investigators. Proposals should be submitted to the corresponding author. Data Access Contact Information: Joseph R. Hribick, hribick@andrews.edu
Study at a glance
From the registry record, last updated by the sponsor on 15 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Immediate Effects of First Rib Mobilization on Pain and Range of Motion in Patients With Shoulder Pain
- ClinicalTrials.gov ID
- NCT07064772
- Acronym / sponsor ID
- 25-095
- Conditions
- Shoulder Pain
- Keywords
- Manual Therapy, Physical Therapy, First Rib, Joint Mobilization, Shoulder Pain
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 64 participants (estimated)
- Lead sponsor
- Andrews UniversityUniversity, hospital or other
- Collaborators
- Lebanon Valley College
- Study start
- 14 Jul 2025 (estimated)
- Primary completion
- 30 Jul 2026 (estimated)
- Study completion
- 30 Jul 2026 (estimated)
- First posted
- 15 Jul 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this clinical trial is to examine whether one session of a specific manual physical therapy technique, known as first rib mobilization, can lead to immediate improvements in pain and movement in individuals with shoulder pain. We hypothesize that this single treatment will result in reduced pain and increased ability to move the shoulder and neck. Researchers will compare first rib mobilization to a sham mobilization (a look-alike hands-on position that does not mobilize the first rib) to see if first rib mobilization works to immediately reduce pain and improve movement in patients with shoulder pain.
Participants will receive first rib mobilization or a sham mobilization during a single session of physical therapy and will receive pre and post intervention measurements of their pain levels and neck and shoulder range of motion.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| First Rib Mobilization Group | Experimental | Other: First Rib MobilizationParticipants in this arm will be randomly assigned to receive a first rib mobilization on their affected side of shoulder pain by a licensed physical therapist. |
| Sham Mobilization | Sham comparator | Other: Sham ComparatorParticipants in this arm will be randomly assigned to receive a sham mobilization to the region of the first rib on their affected side of shoulder pain by a licensed physical therapist. |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Men and Women
- Ages 18-75 years old
- Attending physical therapy
- Primary complaint of shoulder pain
- Pain intensity >3/10 on the Numeric Pain Rating Scale (NPRS)
Key exclusion criteria (7 listed)
- Previous shoulder or neck surgery
- Clinical signs of a full rotator cuff tear (positive drop arm test)
- Having positive MRI findings of a complete rotator cuff tear
- Having a positive Spurling's test
- Having a steroid injection in the cervical spine and/or shoulder in the last two months
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| First Rib MobilizationParticipants in the mobilization group will receive either a seated or supine three stage progressive muscle energy technique (MET) plus a singular high-velocity, low-amplitude thrust (HVLAT) mobilization technique directed to their first rib on their symptomatic side based on the discretion of the treating physical therapist. | Other | First Rib Mobilization Group |
| Sham ComparatorParticipants in the sham mobilization (control) group will be placed in a supine, hook-lying position identical to the mobilization group; however, they will be instructed to inhale and exhale 3 times using diaphragmatic breathing (avoiding upper chest recruitment) as the physical therapist gently rests his or her hand over the area of the upper trapezius muscle just proximal to the first rib to simulate a sham mobilization hand placement. Therefore, physical therapists will not use any significant compressive force to the musculature, perform any tactile cueing for upper chest breathing, perform any mobilizations, nor perform any HVLAT techniques to participants in the sham mobilization group. | Other | Sham Mobilization |
Primary outcome
Range of motion
Time frame: Cervical and shoulder active range of motion will be assessed in participants in both groups at baseline and immediately following the intervention
Cervical and Shoulder active range of motion
Pain Intensity
Time frame: Change in pain intensity from baseline to immediately following intervention in both groups
Pain Intensity will be assessed via the Numeric Pain Rating Scale (NPRS). On this scale, zero is equivalent to no pain and 10 indicates the worst possible pain.
1 secondary outcome
Global Rating of Change
Time frame: This will be administered to participants in both groups immediately after intervention
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jul 2025.
- Individual participant dataSharing planned: Yes. Individual Participant Data (IPD) Sharing Statement Plan to Share IPD: Yes Description: Deidentified individual participant data (IPD) that underlie the results of this study will be shared. Time Frame: Data will be available beginning 3 months following publication and will remain available for 5 years. Access Criteria: Access will be granted to qualified researchers with a methodologically sound proposal, subject to approval by the study investigators. Proposals should be submitted to the corresponding author. Data Access Contact Information: Joseph R. Hribick, hribick@andrews.edu
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing First Rib Mobilization in people with Shoulder Pain, run by Andrews University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 15 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Joseph R Hribick, Doctor of Physical Therapy (717-538-0786, hribick@andrews.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Range of motion (time frame: Cervical and shoulder active range of motion will be assessed in participants in both groups at baseline and immediately following the intervention). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jul 2025; AzTrials last refreshed its copy on 7 Nov 2026.