Cyriax Inferior Capsule Stretching in Idiopathic Adhesive Capsulitis

Study Overview
=================
Brief Summary
-----------------
The objective of study is to find out the effectiveness of cyriax capsular stretching in idiopathic adhesive capsulitis and to find out the combined effect of capsular stretching's, mobilization and conservative treatment on pain and Range of Motion (ROM) in idiopathic adhesive capsulitis.

Detailed Description
-----------------
This Randomized study was carried out at Pakistan Railway Hospital Rawalpindi. A total of 28 patients were screened out as per inclusion criteria and randomly placed into two groups A and B through lottery method. The Visual Analogue scale, Shoulder Pain and Disability Index, and Range of Motion of shoulder joint were used as outcome measures. All the patients were assessed at baseline before intervention and at the completion of 3weeks of treatment.

Official Title
-----------------
Effect of Cyriax Inferior Capsule Stretching in Idiopathic Adhesive Capsulitis

Conditions
-----------------
Adhesive Capsulitis

Intervention / Treatment
-----------------
* Other: Cyriax inferior capsular stretching + Manual Therapy
* Other: Manual therapy


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Idiopathic Adhesive capsulitis phase 1 and phase 2 Follow capsular pattern ( ER > Abduction> IR) Exclusion Criteria: Adhesive capsulitis phase 3 Any intrinsic etiology i.e. rheumatoid arthritis, infection, gout, haemarthrosis or tumor or Arthritis in stage III or in stage II with a spastic end-feel

Ages Eligible for Study
-----------------
Minimum Age: 30 Years
Maximum Age: 70 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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cyriax inferior capsular stretching + Manual Therapy<br>Cyriax inferior capsular stretching + Electrotherapy Manual therapy : Kaltenborn grade 1 and 2 Mobilization Active ROM exercises : Home plan include :, wall walking exercises, pendulum exercises ,towel stretch exercises, Cross Body Adduction | Other: Cyriax inferior capsular stretching + Manual Therapy<br>* Electro-therapy 10mins Manual therapy : Kalternbon grade 1 and 2 Mobilization : Inferior glide (10x3), posterior glide, (10 reps x 3 sets), anterior glide (10 reps x 3 sets), Active ROM exercises : 10 reps x 3 sets Home plan include :, wall walking exercises, pendulum exercises ,towel stretch exercises, Cross Body Adduction (10reps x 2 sets ,each) Cyriax inferior capsular stretching<br>|
| Active Comparator: Manual Therapy<br>Analgesic short-wave diathermy Manual Therapy: Kalternbon grade 1 and 2 Mobilization :, Home plan include :, wall walking exercises, pendulum exercises ,towel stretch exercises, Cross Body Adduction. | Other: Manual therapy<br>* Before starting capsule stretching technique, Analgesic short-wave diathermy may be given for 10 minutes. Kalternbon grade 1 and 2 Mobilization : Inferior glide (10x3), posterior glide, (10 reps x 3 sets), anterior glide (10 reps x 3 sets), Home plan include :, wall walking exercises, pendulum exercises ,towel stretch exercises, Cross Body Adduction (10reps x 2 sets ,each)<br>|

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

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Goniometer | Changes from the baseline, Measure the available range of motion or the position of the shoulder joint - typically this is a measure of passive motion like External Rotation, External Rotation and Internal Rotation. | 3rd week | 
| Visual Analogue Scale (VAS) | Changes from the baseline, Normative values are not presented so by using a ruler , the score is calculated by measure the distance on 10cm line between the no pain point and the patient's mark, provide a range of score from 0-100. A higher score indicates greater pain intensity. | 3rd Week | 
| Shoulder pain and disability index (SPADI) | Changes from the Baseline, SPADI is a self-administered questionnaire that aims to measure pain and disability associated with shoulder disease. It consists of two dimensions, one for pain and second for functional activities. The pain element consists of five questions regarding severity of pain and to measure the degree of severity that an individual faced during various activities of daily life that involve upper extremity use. There are eight questions. Each subscale is summed up and a total SPADI score is expressed as a percentage.Total pain score : --/50 ×100 = %, Total disability score: --/80 × 100 = %, Total SPADI score: --/130 × 100 = %. A score of 0 indicates best 100 indicates worst. A higher score shows more disability. | 3rd week | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Adhesive Capsulitis, Cyriax Manual Therapy, Stretching