Muscle Energy Technique With Or Without First Rib Mobilization In Adhesive Capsulitis
Condition: Adhesive Capsulitis
MeSH terms: Bursitis
Study type: Interventional

Summary: 
      This study will be a randomized control trial. Study will be conducted in 40 patients in the
      age range 40-70 years, which will be selected by using non proability convenient sampling
      technique. Subjects will be divided in 2 groups. Group A will receive first rib mobilization
      along with METS and conventional treatment, group B will receive METS and conventional
      physical therapy treatment only. Treatment will be given thrice per week for 3 weeks. Data
      will be collected pre and post treatment, for data collection numeric pain rating scale,
      shoulder pain and disability index (SPADI) will be used. Joint range of motion will be
      measured using goniometer. After collection data from defined study setting, data will be
      entered and analyzed at Riphah International University, Lahore.
    

Detailed description: 
      Adhesive capsulitis, also known as "frozen shoulder," is a common condition of the shoulder
      defined as a pathologic process in which contracture of the gleno-humeral capsule is a
      hallmark. Clinically, it presents as pain, stiffness, and dysfunction of the affected
      shoulder. Adhesive capsulitis is thought to afflict between 2 and 5% of the general
      population, with women affected more frequently than men. Individuals of middle age are most
      often affected, typically during the 5th to 7th decades of life.

      Muscle energy techniques is a manual therapy that uses the gentle muscle contractions to
      relax and lengthen muscles and normalize joint motion. It is a class of soft tissue
      osteopathic manipulation consisting of isometric contraction designed to improve
      musculoskeletal function and reduce pain. The application of MET relaxes and improves
      biomechanics and result in improving functional ability.

      Although conventional physical therapy treatment are used to treat frozen shoulder and
      effectiveness of muscle energy technique is proven, but the effect of first rib mobilization
      and MET has not been studied.
    

Intervention name(s): first rib mobilization; muscle energy technique
Intervention type(s): Other; Other
Intervention description(s): To perform the first rib mobilization, the patient remained lying supine with the head in the examiner's right hand. Examiner then palpated the left first rib and passively side-bended the patient's head to the left to relieve any muscular tension on the first rib. Patient was then asked to take a deep breath in and out. During exhalation, the examiner applied pressure to depress the first rib, holding it in place at the end of the exhalation. Then, holding the first rib in place, the patient was asked to inhale and exhale deeply again. The examiner continued applying pressure to hold the first rib in a position of relative depression during inhalation, and further depressed the first rib as able during exhalation. This process was repeated three times in two sets, for a total of six first rib depression mobilizations.; Muscle energy technique for glenohumeral joint restricted abduction-The therapist stood in front of the patient, then placed one hand over the top of the subject's involved shoulder. The therapist cups the glenohumeral joint to palpate for motion and the subjects are directed to press the elbow towards their body. Muscle energy technique was applied for five repetitions per set, five sets per session, one session per day, three days a week for three weeks with each repetition maintained for the duration of 7-1 seconds.
Other intervention name(s): first rib maitland mobilization; muscle energy technique for shoulder
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: muscle energy technique, first rib mobilization