Comparison of PFS and ART in Adhesive Capsulitis in Diabetic Patients

Study Overview
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Brief Summary
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To determine the technique that will have better effects in realigning the muscle kinematics and to normalize the muscle activity along with reducing muscle stiffness with mobilizations techniques

Detailed Description
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There is a very limited literature available Active release technique (ART) and Post Facilitation Stretch (PFS) in frozen shoulder. Additionally there is a very limited literature on the evaluation of ART in comparison with PFS in adhesive capsulitis of diabetic patient. Disease such as rheumatoid arthritis (RA), osteoarthritis (OA) etc that cause stiffness of the shoulder joint also present with altered muscle activity, that in long run becomes one of the main causes of reduces joint range of motion. With this study, we will be able to determine the technique that will have better effects in realigning the muscle kinematics and to normalize the muscle activity along with reducing muscle stiffness with mobilizations techniques. This study will also fulfill that research gap and will provide clinicians with an alternative approach in treatment of adhesive capsulitis.

Official Title
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Comparison of Post Facilitation Stretch and Active Release Technique in Adhesive Capsulitis in Diabetic Patients

Conditions
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Adhesive Capsulitis

Intervention / Treatment
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* Other: Post facilitation stretch
* Other: Active release technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Controlled diabetic patients (random 200-250mg/dl /fasting 120-160mg/dl). Grade 2 & 3 of adhesive capsulitis, Pain (NPRS) ranging between 3-10 Reduced normal shoulder ROM's i.e Flexion less than 160 degrees. Extension less than 50 degrees. Abduction less than 170 degrees. External rotation less than 80 degrees. Internal rotation less than 70 degrees Exclusion Criteria: Trauma history of shoulder/surgery. Frozen shoulder accompanied with neurological involvement. People with any injury or disability of elbow or hand

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 55 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Post facilitation stretch<br>Post facilitation stretch with Maitland mobilization | Other: Post facilitation stretch<br>* Post facilitation stretch with maitland mobilization Grade I & II Maitland mobilization of shoulder joint in 1st and 2nd week progressing to Grade III oscillatory mobilization of shoulder joint in 3rd week. It will further progress to Grade IV Maitland oscillatory mobilizations in the 4th or 5th week. Treatment will be provided 3 session/week for 6 weeks with 40 minutes/session<br>|
| Active Comparator: Active release technique<br>Active release technique with Maitland mobilization | Other: Active release technique<br>* Active release technique with maitland mobilization Grade I & II Maitland mobilization of shoulder joint in 1st and 2nd week progressing to Grade III oscillatory mobilization of shoulder joint in 3rd week. It will further progress to Grade IV Maitland oscillatory mobilizations in the 4th or 5th week. Treatment will be provided 3 session/week for 6 weeks with 40 minutes/session<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Shoulder pain and disability Index (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. Each of the 13 items is to be rated with a number from 0 to 10: For the pain score (first 5 items): 0 means no pain and 10 means worst pain imaginable; For the disability score (last 8 items): 0 means no impairment and 10 means the patient requires help to perform that action | 6th week | 
| The oxford scale | The Oxford Scale is a 0-5 scale which is then recorded as 0/5 or 2/5, sometimes with a + or - sign to indicate more or less power but not sufficient to reduce or increase the number. | 6th week | 
| Numeric Pain Rating Scale (NPRS) | The NPRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of his/her pain. The common format is a horizontal bar or line. Similar to the VAS, the NPRS is anchored by terms describing pain severity extremes. | 6th week | 
| ROM Shoulder Flexion | Goniometer is used to measure the range of the motion of the shoulder flexion | 6th week | 
| ROM Shoulder Extension | Goniometer is used to measure the range of the motion of the shoulder extension | 6th week | 
| ROM Shoulder Abduction | Goniometer is used to measure the range of the motion of the shoulder Abduction | 6th week | 
| ROM Shoulder External Rotation | Goniometer is used to measure the range of the motion of the shoulder External Rotation | 6th week | 
| ROM Shoulder Internal Rotation | Goniometer is used to measure the range of the motion of the shoulder Internal Rotation | 6th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pain, Shoulder, Fibrosis, Disability