Mulligan Mobilization Technique and Muscle Energy Technique on Pain and ROM
Condition: Adhesive Capsulitis
MeSH terms: Bursitis
Study type: Interventional

Summary: 
      this study will be a randomized clinical trial. This study will be conducted in Nishat Latif
      Hospital, Barath, Sialkot. A sample size of 22 patients will be taken. Patients will be
      divided into two groups by lottery method. Group A will be treated with mulligan mobilization
      technique and conventional physiotherapy with Transcutaneous electrical nerve stimulation and
      electrical heating pad. Group B will be treated with muscle energy technique and conventional
      treatment of Transcutaneous electrical nerve stimulation and electrical hot pack. Both groups
      will receive treatment for5 weeks,2 sessions in a week with baseline and 6 weeks treatment
      reading will be taken. The outcome measures Numeric pain rating scale, disabilities of the
      arm, shoulder and hand, Shoulder Pain and Disability Index . data will be analyzed by
      Statistical Package for the Social Sciences 25.
    

Detailed description: 
      Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness
      and pain in your shoulder joint. A condition in which a person has severe limitation of the
      range of motion of the shoulder due to scarring around the shoulder joint. Adhesive
      capsulitis is an unwanted consequence of rotator cuff disease that involves damage to the
      rotator cuff. Muscle energy technique involves careful positioning of an area of the body by
      the physical therapist. After positioning, you will be asked to contract the muscle or resist
      a movement done by the physical therapist. This will be followed by a stretch to lengthen the
      same or opposite muscle group.

      This will be followed by a stretch to lengthen the same or opposite muscle group. Mulligan's
      technique "combines the sustained application of manual gliding force to a joint, with the
      aim of repositioning bone positional faults while enabling concurrent physiological
      (osteo-kinematic) motion of the joint. Essentially, this means repositioning a joint to
      enable proper motion while taking that joint through pain-free passive and active range of
      motion (ROM).

      Mulligan Manual Therapy can be used to help treat a variety of injuries and pain including
      neck pain, back pain and upper and lower extremity injuries. Designed to reduce pain and
      improve the patient's range of motion the Mulligan technique involves Natural Apophyseal
      Glides (NAGS), Sustained Natural Apophyseal Glides (SNAGS) and Mobilization with Movement
      (MWM) for the treatment of musculoskeletal injuries.

      The American Academy of Orthopedic Surgeons describe three stages: Freezing, or painful
      stage: Pain increases gradually, making shoulder motion harder and harder. Pain tends to be
      worse at night. Frozen: Pain does not worsen, and it may decrease at this stage. The shoulder
      remains stiff. Thawing: Movement gets easier and may eventually return to normal. Signs and
      symptoms typically begin gradually, worsen over time and then resolve, usually within one to
      three years.
    

Intervention name(s): muscle energy technique; mulligan mobilization technique
Intervention type(s): Other; Other
Intervention description(s): Post facilitation stretch Patient perform isometrics for 15 seconds then therapist rapidly move the shoulder to the end range; Sustain Posterolateral glide with belt and then told Patient to move in following pattern (internal rotation, external rotation, abduction, wall sliding)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Frozen shoulder