“THE EFFECTS OF ANTERIOR VERSUS INFERIOR GLIDE IN IMPROVING FUNCTIONAL ACTIVITY OF THE SHOULDER IN PATIENTS WITH ADHESIVE CAPSULITIS”
Authors: Nandennagari Sailaja , Annam Reshma , Nayakanti Abraham 
Published: April 2020

Adhesive capsulitis is a self‐limiting condition of elderly people with marked deterioration of activities of daily living (ADL) leading to restriction of psychosocial movement (functional limitation). This article determines the improvement of signs of adhesive capsulitis as per force of direction of application (anterior glide versus posterior glide) on glenohumeral joint that would result in the considerable improvement in shoulder external rotation range of motion, abduction and the functional activity in individuals with adhesive capsulitis. The outcome of this study could potentially guide clinical decision making regarding the most effective direction of mobilization to facilitate functional activity of the patients. During this study it is evident that anterior glide overtakes the inferior glide with considerable mean improvement in the patient’s ROM of shoulder joint being marked decrease in pain of both the joints. From the study in a nutshell, it is evident that all measurable parameters such as Range of motion (ROM) through goniometer, pain through visual analog scale (VAS), sensory intensity, emotional impact and the cognitive evaluation of pain through McGill Pain Questionnaire (implies to multidimensional assessment of pain) were towards the positive side. Thirty patients were randomly selected from the community excluding diabetic patients to avoid the bias, effect of diabetic medication over the joint mobilization. All subjects were evaluated with Goniometer, McGill questionnaire and VAS scale before the mobilization techniques implemented. Divided into two groups and were treated with anterior and inferior mobilization techniques characterized as low‐rate, low‐amplitude techniques with sustained loading of restricting tissue at the end ranges of abduction and/or external rotation with a uniform, gliding movement. Each glide (“after the slack of the joint has been taken up”) was given for 1 minute for a total of 15 minutes of sustained stretch, without giving any oscillatory glides after each set and the patient rested in a neutral position for approximately 10 seconds. On an average of 30 degrees of mean ROM increment was observed whereas for pain scale mean reduction in the values from an average of 8 to 3 were seen. Mean and standard deviation for ROM before the joint mobilization (pre‐treatment) as well as the values after the joint mobilization (post‐treatment) were calculated for both anterior and inferior mobilization techniques and progressed to t‐test for each mobilization technique. The same is repeated for pain scale as well. To conclude, there is a strong evidence of improvement in the joint disability as a result of anterior mobilization technique over inferior.Support or Funding InformationAmerican Association for Anatomists

S.NO

GROUP A (ROM)

MEAN

STANDARD DEVIATION

t‐TEST

1

Pre‐treatment

22.5

0.973

5.37

2

Post‐treatment

43.4

4.939

S.NO

GROUP A (VAS)

MEAN

STANDARD DEVIATION

t‐TEST

1

Pre‐treatment

7.8

1.08

3.65

2

Post‐treatment

3.85

0.99