Background: This study evaluated the effectiveness of upper thoracic manipulation (UTM) and proprioceptive training versus proprioceptive training alone on forward head posture (FHP) and cervicocephalic joint position sense (CJPS) in asymptomatic university students during a short interval of time. Objectives: To evaluate whether the suggested combination would provide greater benefit, and be superior to proprioceptive training alone in improving proprioceptive acuity and head posture. Design: A single-blind randomized controlled trial. Methods: Thirty-three university student volunteers with asymptomatic FHP were recruited. Subjects were randomly assigned to a manipulation group (n=16) receiving UTM combined with proprioceptive training or a proprioception group (n=17) receiving proprioceptive training only. The intervention period lasted 5 weeks in total, and consisted of one 15 to 20-minute session per week. FHP and CJPS were assessed before and after the intervention. Results: A significant pre- to post-intervention decrease in FHP and joint position error was identified in both groups (P<.05). Subjects in the manipulation group demonstrated greater improvements in CJPS and head posture compared to the proprioception group (P<.05). Conclusion: These findings support employing either intervention for treating asymptomatic students with FHP. However, the addition of UTM to proprioceptive training was more effective than proprioceptive training alone in reducing joint position errors and improving head posture.

The purpose of this study was to examine the effects of the thoracic spine manipulation on spinal alignment (Cobb angle), pain, and trunk range of motion (ROM) in a patient with mild thoracic scoliosis. The Cobb angle was 11.0° and there was a right deviation of the thoracic spine. The subject had thoracic and lumbar pain, and had felt stiffness during turning of the trunk for about 3 years. Thoracic manipulation was applied at the upper thoracic spine as a therapeutic intervention three times per week for 5 weeks. After intervention, the Cobb angle decreased from 11.0° to 5.5° and the pain score decreased from 4.0 to 1.5, and the trunk left rotation ROM increased from 30.0° to 41.5°, and trunk right rotation ROM increased from 26.0° to 39.0°. These results suggest that the thrust thoracic manipulation technique had a positive effect on the spinal alignment, pain and trunk rotation ROM in patients with mild scoliosis.

The purpose of this case study was to investigate the effects of thoracic mobilization and manipulation on a patient with upper thoracic pain. The subject had been complaining of upper thoracic pain for the last 4 months. On the X-ray, T3 and T4 spinous process were located on the left side of the vertical axis. First, transverse mobilization was applied from left to right at the T3-T4 and then thoracic manipulation was performed. The intervention methods of mobilization and manipulation were based on the concept of Maitland manual therapy. The subject underwent a total of 20 sessions (five times per week for four weeks). The thoracic pain and vertebral rotation angle were measured to examine the effect of the intervention. The thoracic pain score decreased (from 4.0 to 1.5) and the angle of thoracic vertebral rotation decreased (from 7.0º to 4.0º). These results suggest that applied mobilization and manipulation in patients with a primary complaint of thoracic pain decreasing the thoracic pain and vertebral rotation angle.