Effects of Conventional Physical Therapy With and Without Scapular Stabilization Exercises in Adhesive Capsulitis.

Study Overview
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Brief Summary
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The objective of this study will be to determine the Effects of conventional physical therapy with and without scapular stabilization exercises on pain, function, scapular dyskinesia, and proprioception in patients with adhesive capsulitis.

Detailed Description
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Adhesive capsulitis is characterized by the gradual onset of severe shoulder pain with the progressive limitation of active and passive glenohumeral range of motion. Due to capsular tightness and pain, scapular positioning and proprioception get affected. An increase in the abnormal positioning of the scapula and proprioception deficit disturbs the whole biomechanics of the shoulder joint and are the main causes of residual pain and stiffness following PT treatment. In previous studies, several studies have reported the effects of scapular stabilization exercises on pain, ROM, and function but there is a paucity of literature available on specifically addressing scapular dyskinesis and joint position sense in patients with adhesive capsulitis. Scapular stabilization techniques will help to improve proprioception and the length-tension relationship of the scapular muscles, which may effectively reduce the time taken for the rehabilitation of the patient with adhesive capsulitis of the shoulder joint.

Official Title
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Effects of Conventional Physical Therapy With and Without Scapular Stabilization Exercises on Pain, Function, Scapular Dyskinesia and Proprioception in Patients With Adhesive Capsulitis.

Conditions
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Adhesive Capsulitis

Intervention / Treatment
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* Other: conventional physiotherapy
* Other: scapular stabilization exercises along with conventional physiotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of idiopathic adhesive capsulitis for more than 4 months (Stage 2) Unilateral idiopathic adhesive capsulitis Shoulder Pain on NPRS ≥5 Restricted ROM (loss of ≥ 25% relative to non-involved shoulder in one or multidirectional) Patients volunteered to participate in the study and signed informed consent. Exclusion Criteria: History of shoulder surgery or manipulation under anesthesia Unstable fractures, rheumatoid arthritis and those with severe joint pain unrelieved by rest Neurologic deficits affecting shoulder functioning during daily activities Pain or disorders of the cervical spine, elbow, wrist, or hand Other pathological conditions involving the shoulder (rotator cuff tear, tendinitis, etc.)

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 60 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: conventional physiotherapy<br>15 patients will receive conventional physiotherapy including a hot pack, TENS, therapeutic ultrasound, shoulder anteroposterior, posteroanterior, and inferior glides followed by active and active-assisted range of motion exercises, isometric exercises, Codman's pendulum exercises, wand, pulley, and finger ladder exercises. | Other: conventional physiotherapy<br>* Hot pack, TENS, and therapeutic ultrasound will be applied for 10 minutes. Then glides will be given 30 x 3 times in grades III and IV. The rest of the exercises will be prescribed as 3 sets for 10 repetitions with 2 minutes of rest between sets for 6 weeks with respect to 3 sessions per week.<br>|
| Experimental: scapular stabilization exercises along with conventional physiotherapy<br>15 participants will receive conventional treatment along with scapular stabilization exercises program consisting of strengthening exercises (Middle Trapezius, Lower Trapezius, Serratus Anterior, and Rhomboid Muscles) and stretching exercises (Pectoralis Minor, Levator Scapulae, Upper Trapezius, Teres Major). Appropriate exercises will be given to patients according to the type of Scapular Dyskinesia. | Other: scapular stabilization exercises along with conventional physiotherapy<br>* Each stretch will be repeated 3 times. Each active exercise will be progressed from 3 sets of 10 reps to 3 sets of 15 reps. If the subject easily completed 3 sets of 15 reps of active exercise, they will go on to resisted exercises. These will be performed once a day, for 6 weeks, 3 sessions per week.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NPRS for pain | The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). | 6th week | 
| Bubble inclinometer for shoulder ROM and JPS | A bubble Inclinometer is used for measuring the range of motion and joint position sense in patients. | 6th week | 
| SPADI for pain and disability | Shoulder pain and disability index include thirteen questions measuring pain and disability on an eleven-point scale. O being no pain, difficulty and 10 being worst pain and difficulty. | 6th week | 
| LSST for static scapular movement | A lateral scapular slide test is used to assess scapular position in shoulder pathologies. | 6th week | 
| SDT for dynamic scapular movement | The scapular dyskinesia test is used to measure dynamic scapular movement. | 6th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adhesive capsulitis, scapular dyskinesis, proprioception, scapular stabilization exercises