Effects of Gong's Mobilization With and Without Stecco Fascial Therapy in Patients With Adhesive Capsulitis

Study Overview
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Brief Summary
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The aim of this study is to determine the effects of Gong's mobilization with and without Stecco Fascial therapy on pain, range of motion and function in patients with Adhesive capsulitis.

Detailed Description
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Adhesive capsulitis is characterized by a painful, progressive loss of both active and passive glenohumeral mobility that results from the glenohumeral joint capsule's increasing fibrosis and eventual rigidity. The clinical syndrome known as frozen shoulder restricts active and passive range of motion (ROM) in flexion, abduction, and rotation, among other movements. A research conducted on effectiveness of Gong's mobilisation versus muscle energy technique on pain and functional ability of shoulder in phase II adhesive capsulitis. He included 50 subjects and then randomly allocated them into two groups. Duration of treatment was 6 sessions per week for two weeks. The Gong's mobilisation (Group A) pull was maintained for about 10-15 seconds. Maitland's grade 3 and 4 was performed to increase the range. Muscle energy technique was applied for 5 repetitions per set, 5 days a week for 2 weeks. Group A showed significant improvement than Group B. This implies that Gong's mobilisation is more beneficial in improving ROM, reducing pain, improving functional ability. A study conducted to determine the effect of Fascial Manipulation on the Internal Rotation Range of Motion in athletes with GIRD. Asymptomatic overhead athletes with GIRD more than 20° when compared with the non-dominant shoulder were randomly assigned to two groups. The experimental group has received three sessions of FM treatment in two weeks. FM applied to densified Centre of Coordination (CC) points located on the myofascial sequences for 5 to 8 minutes at each CC point. The control group has received three sessions of posterior shoulder capsule release using a tennis ball under supervision.This study indicates that FM may be used as an adjunct to stretching in asymptomatic participants with GIRD to increase the IRROM. There is limited literature available regarding the combined effects of Gong's Mobilization with Stecco Fascial manipulative therapy on pain, range of motion and function in patients with adhesive capsulitis. Previous literature was carried on smaller sample size and for two weeks without any follow up. In previous studies long term effects were not known and only shoulder abduction and internal rotation range of motion were measured. Therefore, in this study combined effects of Gong's mobilization and Stecco Fascial Therapy will be study on pain, range of motion and function in patients with Adhesive Capsulitis. This study will include all range of motion of shoulder joint and also include home plan after the session.

Official Title
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Effects of Gong's Mobilization With and Without Stecco Fascial Therapy in Patients With Adhesive Capsulitis

Conditions
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Adhesive Capsulitis

Intervention / Treatment
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* Other: Gong's Mobilization
* Other: Stecco Fascial Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Both male and female patients Patients with positive capsular pattern of glenohumeral joint which is external rotation, abduction and internal rotation Patients aged 35-60 years with shoulder pain and reduction in range of motion Unilateral stage II frozen shoulder with shoulder pain and stiffness for more than 3 months Exclusion Criteria: Patients with additional cervical or shoulder pathology Patients with shoulder dislocation, rotator cuff rupture and injury Medical red flag history (tumor, metabolic diseases, rheumatoid arthritis, osteoporosis or Infection) Neurological disorder or symptomatic herniated disc or severe disorders of the cervical spine History of Severe trauma or any fracture or surgery

Ages Eligible for Study
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Minimum Age: 35 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
Interventional Model Description: Participants are assigned to one of the treatment arms at the beginning of the trial and continue in that arm throughout the length of the trial.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Gong's Mobilization with Stecco Fascial Therapy<br>Participants in this group will receive Gong's Mobilization with Stecco Fascial Therapy | Other: Gong's Mobilization<br>* The duration of intervention will be 4 weeks, 3 sessions a week, a total of 12 sessions will be given to the study participants. Each session will last for 30 minutes. Baseline treatment will be given to participants along with Gong's Mobilization.<br>Other: Stecco Fascial Therapy<br>* The duration of intervention will be 4 weeks, 3 sessions a week, a total of 12 sessions will be given to the study participants. Each session will last for 30 minutes. Baseline treatment will be given to participants along with stecco fascial therapy.<br>|
| Active Comparator: Gong's Mobilization<br>Participants in this group will receive Gong's Mobilization | Other: Gong's Mobilization<br>* The duration of intervention will be 4 weeks, 3 sessions a week, a total of 12 sessions will be given to the study participants. Each session will last for 30 minutes. Baseline treatment will be given to participants along with Gong's Mobilization.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain: Numeric Pain Rating Scale (NPRS) | Changes from baseline Numeric pain rating scale is The 11-point scale used to capture the patient's level of pain. The scale is anchored on the left with the phrase ''no pain'' and on the right with the phrase ''worst imaginable pain.'' Patients rate their current level of pain and their worst and least amount of pain in the last 24 hours. Numeric pain scales have been shown to be reliable and valid with validity range from 0.86 to 0.95 and high test-retest reliability r=0.96 | 4th week | 
| Range of Motion Shoulder (Flexion) | Changes from baseline ROM range of motion of shoulder flexion will be taken with the help of universal goniometer. | 4th week | 
| Range of Motion Shoulder (Extension) | Changes from baseline ROM range of motion of shoulder extension will be taken with the help of universal goniometer. | 4th week | 
| Range of Motion Shoulder (Abduction) | Changes from baseline ROM range of motion of shoulder abduction will be taken with the help of universal goniometer. | 4th week | 
| Range of Motion Shoulder (External rotation) | Changes from baseline ROM range of motion of shoulder external rotation will be taken with the help of universal goniometer. | 4th week | 
| Range of Motion Shoulder (Internal rotation) | Changes from baseline ROM range of motion of shoulder internal rotation will be taken with the help of universal goniometer. | 4th week | 
| Function: Shoulder Pain and Disability Index (SPADI) Questionnaire | Changes from baseline SPADI. SPADI questionnaire is used for the self-assessment of symptoms and function of the shoulder. 13 items (total score): 5 items for pain and 8 for function (sub scores). Response options/scale. All SPADI items are originally scored on a visual analog scale (VAS) from no pain/no difficulty to worst pain imaginable/so difficult required help. The VAS line was divided into 12 equal intervals to obtain a 12-point numerical rating scale (NRS) ranging from 0 (best) to 11 (worst). | 4th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Adhesive Capsulitis, Pain, Range of Motion