Comparative Effects of Myofascial Arm Pull and Post Isometric Relaxation Techniques in Adhesive Capsulitis
Condition: Adhesive Capsulitis
MeSH terms: Bursitis
Study type: Interventional

Summary: 
      Adhesive capsulitis is defined as a condition characterized by pain and stiffness in shoulder
      which results in both active and passive movement loss. The purpose of this study is to
      investigate the effects of shoulder directed treatment approach using Myofascial arm pull
      technique on the pain, range of motion and quality of life in patients with adhesive
      capsulitis and compare its effectiveness with Post Isometric Relaxation technique.
    

Detailed description: 
      Frozen shoulder is a common debilitating disorder characterized by shoulder pain and
      progressive loss of shoulder movement. Frozen shoulder is frequently associated with other
      systemic conditions or occurs following periods of immobilization, and has a protracted
      clinical course, which can be frustrating for patients as well as health-care professionals
      .Loyd define secondary frozen shoulder as a condition resulting from painful spasm on
      shoulder which causes activity limitation and dependency on opposite arm. In general
      population, the prevalence rate of frozen shoulder is around 2% to 5% and it ranges from 11%
      to 30% in diabetic population. Women are affected more than male and approx. 70% cases of
      frozen shoulder are on female. Among all frozen shoulder cases; around 20% to 30% patients
      develop frozen shoulder on opposite shoulder. Most of the frozen shoulder cases develop on
      non dominant shoulder. Adhesive Capsulitis of Shoulder is seen commonly at age of 40-65
      years. Traditionally, FS has been regarded as a self-limiting and benign disease with
      complete recovery of pain and ROM. However, this condition can sometimes last for years. In
      one study, 50% of patients were still experiencing pain or stiffness of the shoulder at a
      mean of 7 years from the onset of the condition, although only 11% reported functional
      limitation. Different Physical therapy interventions used in patients with frozen shoulder
      frequently include modalities, manual techniques, and therapeutic exercise. Exercises given
      in the treatment of adhesive capsulitis consists of active ROM, Codman's exercise, wall
      walks, shoulder wheel, pulley, active and passive stretching, and rotator cuff and scapular
      strengthening exercises, METs, Gong mobilization, Mulligan mobilization. Many strategies have
      been employed in clinical practice to improve range and strength in prior research. There are
      limited studies regarding comparisons between the effects of myofascial arm pull and post
      isometric relaxation techniques that give the evidence of improving end painful ranges of
      adhesive capsulitis for long term effect. This study will be conducted to check the positive
      effect of myofascial arm pull technique and post isometric relaxation to increase end range
      in adhesive capsulitis. The literature review was conducted using different databases and the
      eleven selected articles fulfilled the criteria and included in research. Conclusion:
      Addition of Myofascial release technique and post isometric relaxation technique both as an
      adjunct to conventional treatment will have better benefits and faster recovery in patients
      with frozen shoulder but there are limited studies about the comparison of myofascial arm
      pull and post isometric relaxation techniques on pain, range of motion and quality of life in
      adhesive capsulitis. I will conduct this study to determine which technique is better to gain
      painful end ranges in adhesive capsulitis. So that this study will provide different
      treatment strategies for frozen shoulder to improve end painful ranges.
    

Intervention name(s): Myofascial arm pull technique; post isometric relaxation technique
Intervention type(s): Other; Other
Intervention description(s): patient in supine position move the arm passively in abduction to the restricted barrier and pull the arm only enough traction was used to counterbalance the weight of the patient's arm. Stretch was hold until the fibers were released, and then, stretch was given again by increasing traction. This sequence was repeated until an end feel was reached. same procedure for flexion and scapular protraction and Horizontal-adduction. Repetition will be 4-5 reps. per set, 3 times per week for 18 sessions.; 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 gleno humeral joint to palpate for motion and the subjects are directed to press the elbow towards therapist hand for shoulder abduction, internal rotation and external rotation. Muscle energy technique was applied for five repetitions per set, five sets per session, one session per day, three days a week for six weeks with each repetition maintained for the duration of 7-10 second
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Adhesive Capsulitis, Pain, Shoulder, Joint Range of Motion