Thoracic spine mobility, an essential link in upper limb kinetic chains in athletes: A systematic review

Knowledge of the contribution of the thoracic spine movement, a requisite for UL functional movement, offers the potential for novel directions for research and management in rehabilitation. This systematic reviewed synthesized evidence of thoracic spine mobility during UL movement in athletes. Using three reviewers at each stage, key databases (MEDLINE, CINAHL, Web of Science) were searched up to 30/6/18. Eligibility criteria: adults age 18-40 (reflecting athletic population) and studies assessing thoracic spine and UL movement. Quality assessment was evaluated using AXIS tool and GRADE for overall quality of evidence. Seven studies were included (n = 168, mean age 26.4 years, 33% males) with n = 20 in an athlete population. Main findings were: Unilateral and bilateral UL flexion resulted in 6.7-8.0 and 12.0-12.8° thoracic extension, respectively. Unilateral and bilateral UL abduction resulted in 3.0-4.0 and 9.0-15.0 and degrees, respectively. Other thoracic spine movement (lower and upper, rotation and lateral flexion) was variable across movement planes. Overall there was unequivocal evidence of thoracic spine movement, mainly extension during UL movement and notably at the end of elevation across all planes. Findings support further targeted high-quality research and examination of thoracic mobility, an essential link in the kinetic chain, in practice.