Effects of Kaltenborn Translatoric Glides As Compared to Traction Mobilization in the Management of Frozen Shoulder

Frozen shoulder is a common musculoskeletal condition. Painful gradual loss of both active and passive gleno-humeral motion resulting from progressive fibrosis and ultimate contracture of the gleno-humeral joint capsule.Range of motions and capsular pattern affected in frozen shoulder. Physiotherapists have a wide range of options in managing frozen shoulder including Electrotherapeutic modalities, kaltenborn mobilization, Maitland's mobilization,Mulligan's mobilization and Manipulation. So far studies have shown the efficacy of different treatments in combination or in isolation.some studies on Kaltenborn mobilization , but no obseved comparative effects of Kaltenborn mobilization i.e translatoric glides and traction mobilzation in patients with frozen shoulder.In clinically both techniques of kaltenborn are used but there is no evidence regarding which one is more effective. .If found effective,this study can help to use best clinical treatment in the managemnent of frozen shoulder.

Frozen shoulder is a common MSK condition with an insidious onset accompanied by stiffness and trouble sleeping on the affected side.This condition effects General population 2-5% globally, diabetics 10-20%. Women have a significantly higher incidence males 70% of cases are female.frozen shoulder is a painful, gradual loss of both active and passive gleno-humeral motion resulting from progressive fibrosis and ultimate contracture of the gleno-humeral joint capsule.

The capsule in frozen shoulder tightens,thickness and adheres to bone it causes severe limiting of both osteikinetics and arthrokinetics shoulder range of motion,resulting in long term functional disability.As the capsule thickens mobility limitations occurs in capsular pattern.Kalternborn traction mobilization helpful in breaking capsular adhesions and decreasein severe pain, Improving shoulder limitation such as external roation ,abduction and internal rotation kaltnborn translatoric glides effective.

These mobilization changes the relative capsular adhesions and reduce stress on Gleno-humeral joint.

In clinically both techniques of kaltnborn joint mobilization are used but there is no evidence which one is more effective in the management of frozen shoulder.

Hence the current study will investigate the effects of Kaltenborn linear tranlatoric glides as compared to traction mobilization mobilization on shoulder range of motion and pain in patients with adhesive capsulitis.

This study includes Subjects with nonspecific adhesive capsulitis without specific identifiable etiology (i.e. infection, inflammatory disease) ,40-65 years of age both males and females and chronic shoulder pain \> 3 months,positive capsular pattern.The selection of subjects will be using non-probability purposive sampling technique.Participants will be randomized using sealed envelope method and allocated to one of the 3 groups.

The data collection tools for pain is VAS, for ROM goniometer is used , for FEAR used fear avoidance belief questionnaire and for functional disablity is SPADI.

The time duration for treatment protocol is total of 10 sessions, 5 sessions per week for 2 consecutive weeks for approximately 25-30 mins.

Eligibility Criteria:
Inclusion Criteria:

* Subjects with Nonspecific frozen shoulder without specific identifiable etiology (i.e. infection, inflammatory disease)
* 40-65 years of age both males and females.
* Chronic shoulder pain \> 3 months.
* Positive capsular pattern.

Exclusion Criteria:

* Patients with other shoulder joint pathologies, such as fractures or dislocations, glenohumeral instability or rotator cuff pathologies in the affected shoulder.
* Subjects who have undergone surgery or have experienced an acute trauma to the shoulder.
* Individuals with current or history of neurological disorders (such as stroke, Alzheimer's, or Parkinson's), rheumatologic diseases (such as rheumatoid arthritis or systemic lupus erythematous), or systemic illnesses (such as thyroid disease).