Effectiveness of Kaltenborn Mobilizations Versus Muscle Energy Technique in Adhesive Capsulitis.

Study Overview
=================
Brief Summary
-----------------
Total of 30 patients are selected according to inclusion criteria by convenient sampling and randomly allocated by sealed envelop method into two groups. Group 1 is treated with Muscle energy technique(Post isometric relaxation) and Group 2 is treated with Grade II,III Kaltenborn mobilizations and both groups also receives conventional therapy in form of Codman exercise and Wall ladder exercises.Data will be collected at baseline then after 2 weeks and after 4 weeks of intervention.

Detailed Description
-----------------
The purpose of study is to determine effectiveness of muscle energy techniques(Post Isometric relaxation) and Kaltenborn mobilizations and to compare the effectiveness of both techniques on pain and functional disability in patients with Adhesive capsulitis.Several studies about the effects of Maitland mobilizations and Muscle energy technique have been conducted. Evidence regarding the comparison of Kaltenborn mobilizatuons and post isometric relaxation is sparse. There has been no work regarding effectiveness of these two techniques in improving pain and functional disability in patients of Adhesive capsulitis. Kaltonborn Mobilizations involves the application of a passive sustained stretch technique to enhance joint mobility without articular surface suppression. The forces applied to increase joint mobility are graded from I-III. Grade I applies a distraction of minor intensity that hardly causes stress within the joint capsule; it is often used to decrease pain. Grade II refers to a force that stretches the periarticular tissue; such stimulus is colloquially referred to as taking up the slack. Finally, Grade III force causes enough distraction or gliding so that joint capsule can sufficiently stretch; it is often used for enhancing ROM. MET is unique in its application as the client provides the initial effort while the practitioner facilitates the process. One of the main uses of this method is to normalize joint range, rather than increase flexibility, and techniques can be used on any joints with restricted Range of Motion (ROM) identified during the passive assessment. The main effects of MET can be explained by two distinct physiological processes: Post Isometric Relaxation (PIR) and Reciprocal Inhibition (RI). Post isometric contraction decrease muscle tone in single group of muscle after brief period of submaximal isometric contraction of same muscle.

Official Title
-----------------
Effectiveness of Kaltenborn Mobilizations Versus Muscle Energy Technique in Adhesive Capsulitis.

Conditions
-----------------
Adhesive Capsulitis of Shoulder

Intervention / Treatment
-----------------
* Other: Muscle energy technique
* Other: Kaltonborn mobilizations


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age between 20 and 60 years. Duration of complaint for more than 3 months. Gender: Both Male and Female. Patients with idiopathic frozen shoulder Patients having restriction in more than 2 ranges Patients with diabetes Exclusion Criteria: Shoulder dislocation, fracture or labral tear. Shoulder girdle motor control deficit associated with neurological disorder. Any bony deformities acquired or congenital in glenohumeral joint. Patients with language barrier.

Ages Eligible for Study
-----------------
Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: There are two groups Group 1 and 2.Group 1 is treated with Muscle energy techniques and Group 2 is treated with kaltenborn mobilizations for 30 minutes per session,3 days per week for 4 weeks.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group A<br>Muscle energy technique | Other: Muscle energy technique<br>* Post Isometric relaxation(muscle energy technique) 3 days/ week for 4 weeks<br>|
| Experimental: Group B<br>Kaltonborn mobilizations | Other: Kaltonborn mobilizations<br>* Kaltonborn mobilizations grade II and III will be performed on Glenohumeral joints 3 days/ week for 4 weeks.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Shoulder pain and disability index | Shoulder pain and disability index is used to measure pain and functional disability level. Total scores range from 0 to 130 with a percentage score of 0 indicating less shoulder disability and 100 indicating more shoulder dysfunction | 4 weeks | 
| Universal goniometer | universal goniometer is used to measure shoulder range of motion. | 4 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Adhesive Capsulitis,Mobilizations, muscle energy technique