Gong v/s Kaltenborn Mobilization in Frozen Shoulder
Condition: Frozen Shoulder
MeSH terms: Bursitis
Study type: Interventional

Summary: 
      The aim of this research is to determine the effects of Gong mobilization and Kaltenborn
      mobilization in patients of frozen shoulder. This is a Randomized clinical trial. The sample
      size is 40. The subjects are divided in two groups, with 20 subjects in Group A and 20
      subjects in Group B. Study duration is of 6 months. Sampling technique applied is
      Nonprobability Purposive Sampling. Both males and females of aged 40-65 years with Stage-II
      frozen shoulder are included. Tools used in the study are Visual Analogue Scale (VAS),
      Goniometer, and SPADI (Shoulder pain and disability index) questionnaire.
    

Detailed description: 
      Adhesive capsulitis or periarthritis, more commonly termed as frozen shoulder is a
      pathological process where adhesions are formed across glenohumeral joint causing
      debilitating pain and movement restrictions. The pathology is categorized as primary, being
      idiopathic and occur spontaneously without any inciting event, or secondary which occur as a
      result of some identifiable disorder such as diabetes mellitus (where a cascade of
      inflammatory reactions, collagen build-up and other extracellular components lead to tendon
      fibrosis and dysfunction, presenting as diabetic frozen shoulder) or some other inciting
      event. The incidence of frozen shoulder is evident to be 3-5% in general population while
      it's up to 20% in diabetic patients. Further it is more evident in females aged 40-60 years.
      Moreover frozen shoulder is classified into four stages which include Stage-I characterized
      by painful shoulder at rest and disturbed sleep, lasting up to 3 months; Stage-II termed the
      "freezing stage" is identified by chronic pain along with restrictions in range of motion
      (ROM) and last up to 9 months; Stage-III called the "frozen stage" where a considerable
      reduction in ROM and a rigid end feel is observed and occurs during 9 to 15 months of onset;
      Stage-IV is "thawing phase" where ROM improves progressively, as frozen shoulder is a
      self-limiting condition and lasts from 15 to 24 months.

      The standard exercise protocol followed for management of frozen shoulder include active and
      active assisted exercises, Codman exercises, wall and ladder exercises, wand exercises,
      capsular stretching, and shoulder joint mobilization. The electrotherapeutic modalities
      employed include ultrasound to resolve inflammation, interferential therapy and
      transcutaneous electrical nerve stimulation (TENS) for pain control and thermal therapy to
      relieve pain and improve muscles extensibility.

      Manual therapy techniques of mobilization have been proved to be very effective in treating
      frozen shoulder. The Gong's mobilization technique which combines the concepts of distraction
      and Maitland, is explained as end range mobilization where an antero-posterior glide is
      applied in dynamic position of the shoulder joint followed by distraction and performance of
      the restricted movement. The technique serves to reduce pain and improve range of motion and
      is significant in producing immediate effects. Kaltenborn mobilization technique depends on
      concave rule and gives grades of traction which include loosening, tightening and stretching
      of the soft connective tissues.
    

Intervention name(s): Gong Mobilization; Kaltenborn Mobilization
Intervention type(s): Other; Other
Intervention description(s): Patients are treated with Gong mobilization protocol along with conventional therapy including ultrasound therapy, hot pack and conventional exercises consisting of codman exercises, ROM exercises and shoulder stabilization exercises.
Total of 3 sessions per week for 3 consecutive weeks.; Patients are treated with Kaltenborn mobilization protocol along with conventional therapy including ultrasound therapy, hot pack and conventional exercises consisting of codman exercises, ROM exercises and shoulder stabilization exercises.
Total of 3 sessions per week for 3 consecutive weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Gong mobilization; Kaltenborn mobilization; Frozen shoulder