Clinical trial NCT04878848: Proprioceptive Neuromuscular Facilitation Techniques in Patients With Adhesive Capsulitis
Official title: Effectiveness of Proprioceptive Neuromuscular Facilitation Techniques in Patients With Adhesive Capsulitis
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Adhesive Capsulitis
Shoulder Pain
Shoulder Frozen
Lead sponsor: Istanbul University - Cerrahpasa
Sponsor class: OTHER
First posted: 2021-05-10
Enrollment: 30
Sex: ALL
Minimum age (years): 35
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Within the scope of the research, it is planned to apply a traditional rehabilitation program consisting of stretching and strengthening exercises prepared in accordance with the guidelines for one group, and PNF approaches for the upper extremity and scapula in the other group.
Primary purpose: TREATMENT

Brief summary: Adhesive capsulitis is a condition that causes limitation of function and movement in the shoulder joint and affects many activities of daily life. The clinical indicators of adhesive capsulitis; shoulder pain and progressive global stiffness of the glenohumeral joint, night pains and accompanying sleep disturbances, joint capsule contracture, decrease in synovial fluid, abnormal changes in scapular position, functional limitation and consequently decreased quality of life. When we look at the literature, it is seen that traditional rehabilitation practices aim to improve range of motion and reduce pain caused by capsular contracture. In this context, classical therapeutic exercises consisting of stretching and strengthening, joint mobilization methods, proprioceptive neuromuscular facilitation methods are applied. However, there are limited number of studies investigating the effects of PNF techniques on pain, function and activity limitation. Therefore, within the scope of the research, it is planned to apply a traditional rehabilitation program prepared in accordance with the guidelines for one group, and PNF approaches for the upper extremity and scapula in the other group. Thus, it is aimed to examine the effects of the use of upper extremity and scapula PNF techniques on pain, function, range of motion, proprioception, quality of life, sleep and patient satisfaction compared to traditional exercises in adhesive capsulitis rehabilitation. Exercises will be applied 3 days a week for 4 weeks. Each training session will last 45 minutes. Pain, function, range of motion, proprioception, quality of life and sleep quality evaluations will be performed at the beginning of the study and at the end of 4 weeks.

Detailed description: Adhesive capsulitis is a shoulder pathology characterized by contracture of the glenohumeral joint capsule and progressive pain with loss of range of motion. The disease picture is generally examined in 3 phases as painful phase, freezing phase and thaw phase. It is generally characterized by pain, decreased range of motion, function, activity limitations, night pain and sleep disturbances. Sleep disturbances associated with function, activity limitations and night pain negatively affect the patients' quality of life. In the literature, the success rate of conservative treatment is shown as 90%.

Conservative treatment consists of nonsteroidal anti-inflammatory drugs, corticosteroids, and therapeutic exercises. The purpose of therapeutic exercises in general; to reduce pain, increase range of motion, decrease activity limitations, increase scapulohumeral rhythm by correcting impaired shoulder joint biomechanics and improve function. Proprioceptive neuromuscular facilitation (PNF) is an exercise concept that uses proprioceptors to increase responses of the neuromuscular mechanism, range of motion and muscle activation. PNF techniques are applied to improve muscle strength, endurance, mobility, stability, coordination and neuromuscular control and can be easily adapted to daily life activities.

In the literature, it is aimed to increase the glenohumeral joint movements and regulate the scapulothoracic rhythm in the rehabilitation of adhesive capsulitis. However, the number of studies in the literature comparing upper extremity and scapular PNF patterns with classical exercises targeting the glenohumeral and scapulothoracic joints is limited. For this reason, the aim of the study is to focus on the structures involved in shoulder movements in adhesive capsulitis rehabilitation as a whole, and to examine the effects of the use of upper extremity and scapula PNF techniques on pain, function, range of motion, proprioception, quality of life, sleep and patient satisfaction compared to traditional exercises in patients with a diagnosis of adhesive capsulitis.

Eligibility criteria: Inclusion Criteria:

* Being diagnosed with unilateral adhesive capsulitis (stage II-III)
* Being between at the ages of 35-65
* Complaints ongoing for at least 3 months

Exclusion Criteria:

* Rheumatological diseases such as rheumatoid arthritis, ankylosing spondylitis
* Being diagnosed with glenohumeral joint osteoarthritis, rotator cuff injury, radiculopathy
* Neurological diseases such as cerebrovascular accident, multiple sclerosis, Parkinson's disease, thoracic outlet syndrome
* Dislocation, subluxation, fracture, infection, tumor
* History of shoulder surgery
* People who cannot cooperate with physiotherapist and exercises.

Primary outcomes:
measure: Disabilities of the Arm, Shoulder, and Hand Questionnaire
timeFrame: Baseline and end of weeks 4.
Secondary outcomes:
measure: Evaluation of Shoulder Proprioception with Cybex Humac Norm II Isokinetic Dynamometer
timeFrame: Baseline and end of weeks 4.
measure: Visual Analog Scale
timeFrame: Baseline and end of weeks 4.
measure: Shoulder Pain and Disability Index
timeFrame: Baseline and end of weeks 4.
measure: Shoulder Disability Scale
timeFrame: Baseline and end of weeks 4.
measure: Range of Motion Assesment
timeFrame: Baseline and end of weeks 4.
measure: Lateral Scapular Slide Test
timeFrame: Baseline and end of weeks 4.
measure: Pittsburgh Sleep Quality Index
timeFrame: Baseline and end of weeks 4.
measure: World Health Organization Quality of Life Evaluation Questionnaire Short Form Turkish Version
timeFrame: Baseline and end of weeks 4.
measure: Global Rating of Change
timeFrame: End of weeks 4.
Other outcomes:
Locations:
city: Istanbul
country: Turkey
facility: Istanbul University Cerrahpasa
Study officials:
affiliation: Istanbul University - Cerrahpasa
name: Yonca Zenginler Yazgan, Assistant Professor
role: STUDY_DIRECTOR
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