Comparison of Theraband, Co-contraction and Isometric Exercises in Frozen Shoulder

Study Overview
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Brief Summary
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This project was a Randomized control trial conducted to check the effects of in patients with chronic frozen shoulder theraband, isometric and co-contraction exercises so that we can have best treatment option for patients with chronic frozen shoulder. upper cross syndrome, duration was of 6months,convenient sampling was done, subject following eligibility criteria from DHQ hospital Sheikhupura, were randomly allocated in three groups via lottery method, baseline assessment was done, Group A participants were given baseline treatment along with theraband exercises , Group B participants were given baseline treatment along with co-contraction exercises and Group C were given baseline treatment along with isometric exercises on 3rd and 6th week, post intervention assessment was done via, Numeric pain rating scale(NPRS),Shoulder Pain And Disability Index (SPADI) and goniometric measurements of shoulder ranges ,3 sessions per week were given, data was analyzed by using SPSS version 26.

Detailed Description
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Frozen shoulder is among the most commonly reported problems to physicians, orthopedics and physical therapists. Even before reporting to clinics there is long history of using over the counter pain killers. Pain avoidance behaviors let the joint stiff so much that a clinician help is sought. Most times the cause of frozen shoulder is not known, therefore is termed as 'idiopathic frozen shoulder'.There is huge literature regarding the management of frozen shoulder and yet after the decades of research there are gaps in treatment options. In modern age of health care, it is common goal of every health care to make patient self-sufficient as early as possible. The self-care models have tremendous advantages. The current study has compared the use of theraband, co-contraction and isometric exercises. The current study was novel in a way that there is limited literature about treating shoulder hypomobility with physical strengthening exercises. All three methods were employed to see if they improve ranges along with accompanying pain and disability.

Official Title
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Comparison of Theraband, Co-contraction and Isometric Exercises in Patients With Chronic Frozen Shoulder

Conditions
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Frozen Shoulder

Intervention / Treatment
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* Other: Theraband exercises
* Other: Co-contraction exercises
* Other: Isometric exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Idiopathic with 6 month chronicity. Patients with AROM/PROM less than or equal to 90 degrees. Affected shoulder has not more than 90 degrees of abduction & 50% decreased external rotation as compared to normal side/normal ROM values. Exclusion Criteria: Traumatic & diabetic. Patient with any cervical or thoracic problem. Patients with any intra-articular injection in glenohumeral joint. Patients with rotator cuff complete tear. Patients with any other serious pathology/red flags

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Theraband exercises<br>Group A: baseline physical therapy treatment along with theraband exercises | Other: Theraband exercises<br>* Group A performed theraband exercises for 6 weeks.In the first 2 weeks theraband with low resistance was used to perform exercises and then we proceeded gradually with higher resistance therabands.Theraband exercises was performed for Shoulder Flexion,Shoulder Extension Strengthening, Shoulder Internal Rotation Strengthening, Shoulder External Rotation Strengthening, Shoulder Abduction, Empty Can Exercise & Rowing Exercise with 8-10 reps, 3sec hold and 2-3 sets With each of these exercises<br>|
| Experimental: Co-contraction exercises<br>Group B: baseline physical therapy treatment along with co-contraction exercises | Other: Co-contraction exercises<br>* Muscle co-contraction is the simultaneous contraction of the muscles acting around a joint. Subject stood upright & contracted both the groups (agonist and antagonist) simultaneously without bringing movement at shoulder joint with 6-8 reps , 3sets & 5- 15 seconds duration of sustained self-arm bracing or stiffening was maintained. On eligible participants baseline assessment was done,3 session were given 3days per week, post intervention assessment was taken at 3rd and 6th week<br>|
| Experimental: isometric exercises<br>Group C: baseline physical therapy treatment along with isometric exercises | Other: Isometric exercises<br>* Isometric exercises of shoulder were performed in subjects for 6 weeks which included isometric Shoulder flexion, shoulder abduction isometric exercise, isometric shoulder external rotation, isometric shoulder internal rotation & isometric shoulder extension with 8-10 reps, 5 sec hold and 2 sets. On eligible participants baseline assessment was done,3 session were given 3days per week, post intervention assessment was taken at 3rd and 6th week<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric Pain rating scale (NPRS) | Changes from base Line Numeric Pain rating scale is a scale for pain starting from 0-10. where 0 indicate no pain and 10 indicate severe pain | 3rd day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| SPADI | The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire that consists of two dimensions, one for pain and the other for functional activities. The pain dimension consists of five questions regarding the severity of an individual's pain. Functional activities are assessed with eight questions designed to measure the degree of difficulty an individual has with various activities of daily living that require upper-extremity use. The SPADI takes 5 to 10 minutes for a patient to complete and is the only reliable and valid region-specific measure for the shoulder. | 3rd day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Theraband, Co-contraction Isometric, Frozen Shoulder