A Comparative Study to Assess the Effectiveness of Soft Tissue Mobilization Preceding Joint Mobilization Technique in the Management of Adhesive Capsulitis
Background: Adhesive capsulitis is a condition wherein the shoulder capsule of the glenohumeral joint becomes inflamed and stiff along with adhesion formation. Mobilisation techniques and soft tissue manipulations are important interventions in the management. Both, soft tissue manipulation and joint mobilisation are proven to be effective in treatment of adhesive capsulitis in the past. However logical thinking warranted the need to study the effects of prior use of soft tissue mobilisation of the periarticular structures, which primarily get affected in adhesive capsulitis, followed by joint mobilisation techniques around the glenohumeral joint. Thus our study compared the efficacy of treatment strategies to improve the extensibility of soft tissues i.e; Myofascial release Armpull technique and Maitland's joint mobilization technique in patients with adhesive capsulitis.
Aim: To study the effects of Maitland's mobilization when preceded by Myofascial Release Arm pull technique in patients with Adhesive capsulitis.
Methodology: 30 subjects fulfilling the inclusion criteria were selected and randomly allocated into 2 Groups, Group I: Control Group - Maitland's mobilization + Exercises, Group II: Experimental Group - MFR Arm pull + Maitland's mobilization + Exercises. Brief assessment of Pain, Disability and Range of motion was done by using Visual Analogue Scale, Goniometric measurements and Shoulder Pain And Disability Index.
Results: Statistical analysis showed significant improvement in pain reduction, functional ability and ROM in both Group 1 and Group 2. However when all the outcome measures were compared between the 2 Groups, significant difference was observed in Myofascial release Arm pull technique preceding Maitland's mobilization with respect to pain, function and ROM.
Conclusion: Soft tissue mobilization comprising of Myofascial release Arm pull technique when given prior to Maitland's mobilization showed significant results in reducing symptoms as well as improving functional abilities in Adhesive capsulitis.
- Green S, Buchbinder R, Hetrick S. Physiotherapyinterventions for shoulder pain. CochraneDatabase Syst Rev.2003;(2):CD004258.
- Cynthia C. Norkin. A measurement of JointMotion.A guide to Goniometry.2nd edition.Chp4: The Shoulder.
- Mao C, Jaw W, Cheng H. Frozen shoulder:correlation between the response to physicaltherapy and follow-up shoulder arthrography. Arch Phys Med Rehabil.1997;78:857 – 859.
- Robert A. Donatelli. Physical therapy of theshoulder, 4th edition, Chpt 11- Frozen shoulder,pg 320.
- Wyke B: The neurology of joints. Ann R Coll SurgEngl 41: 25 – 50, 1967.
- Nicholson GG. The effect of passive jointmobilization on pain and hypomobilityassociated with adhesive capsulitis of the98 Indian Journal of Physiotherapy & Occupational Therapy. January-March 2014, Vol. 8, No. 1shoulder. J Ortho sports phys Ther.1985;6:238 – 246.
- Vermeulen HM, Rozing PM, Obermann WR, etal. Comparison of high-grade and low- grademobilization techniques in the management ofadhesive capsulitis of the shoulder: randomizedcontrolled trial. PhysTher. Mar 2006;86(3):355-68.
- Robert I. Cantu, Alan J. Gordin. MyofascialManipulation.Theory and clinicalapplication.2nd edition, Aspen publications, Chpt4, pg 58.
- Darlene Hertling and Randolph M. Kessler. Management of common musculoskeletaldisorders. Physical therapy principles andmethods, 4th edition, Lippincott Williams andWilkins. Chpt 7, pg 129.
Abstract Views: 968
PDF Views: 0