Clinical trial NCT04993092: Mulligan Mobilization Technique and Muscle Energy Technique on Pain and ROM
Official title: Comparative Study on the Effects of Mulligan Mobilization Technique and Muscle Energy Technique on Pain and Range of Motion in Adhesive Capsulitis
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Adhesive Capsulitis
Keywords: Frozen shoulder
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2021-08-06
Enrollment: 22
Sex: ALL
Minimum age (years): 40
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: this study will be a randomized clinical trial. This study will be conducted in Nishat Latif Hospital, Barath, Sialkot. A sample size of 22 patients will be taken. Patients will be divided into two groups by lottery method. Group A will be treated with mulligan mobilization technique and conventional physiotherapy with Transcutaneous electrical nerve stimulation and electrical heating pad. Group B will be treated with muscle energy technique and conventional treatment of Transcutaneous electrical nerve stimulation and electrical hot pack. Both groups will receive treatment for5 weeks,2 sessions in a week with baseline and 6 weeks treatment reading will be taken. The outcome measures Numeric pain rating scale, disabilities of the arm, shoulder and hand, Shoulder Pain and Disability Index . data will be analyzed by Statistical Package for the Social Sciences 25.

Detailed description: Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. A condition in which a person has severe limitation of the range of motion of the shoulder due to scarring around the shoulder joint. Adhesive capsulitis is an unwanted consequence of rotator cuff disease that involves damage to the rotator cuff. Muscle energy technique involves careful positioning of an area of the body by the physical therapist. After positioning, you will be asked to contract the muscle or resist a movement done by the physical therapist. This will be followed by a stretch to lengthen the same or opposite muscle group.

This will be followed by a stretch to lengthen the same or opposite muscle group. Mulligan's technique "combines the sustained application of manual gliding force to a joint, with the aim of repositioning bone positional faults while enabling concurrent physiological (osteo-kinematic) motion of the joint. Essentially, this means repositioning a joint to enable proper motion while taking that joint through pain-free passive and active range of motion (ROM).

Mulligan Manual Therapy can be used to help treat a variety of injuries and pain including neck pain, back pain and upper and lower extremity injuries. Designed to reduce pain and improve the patient's range of motion the Mulligan technique involves Natural Apophyseal Glides (NAGS), Sustained Natural Apophyseal Glides (SNAGS) and Mobilization with Movement (MWM) for the treatment of musculoskeletal injuries.

The American Academy of Orthopedic Surgeons describe three stages: Freezing, or painful stage: Pain increases gradually, making shoulder motion harder and harder. Pain tends to be worse at night. Frozen: Pain does not worsen, and it may decrease at this stage. The shoulder remains stiff. Thawing: Movement gets easier and may eventually return to normal. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.

Eligibility criteria: Inclusion Criteria:

* Pain in shoulder for at least 3 months
* Unilateral frozen shoulder of stage 3 and 4
* Capsular pattern i.e. (lateral rotation, Abduction, Medial rotation)

Exclusion Criteria:

* Secondary capsulitis
* Shoulder injury such as proximal humerus fracture.
* History of Neurological deficit i.e. cervical stenosis, myelopathy.
* Prolong immobilization due to cardiothoracic surgery, neurosurgery.
* Shoulder surgical history such as shoulder arthroplasty.
* History of other pathological condition of shoulders i.e. Impingement syndrome, rotator cuff tear or any shoulder injury

Primary outcomes:
measure: The Quick Disabilities of the Arm, Shoulder and Hand
timeFrame: 4th week
measure: The Shoulder Pain and Disability Index
timeFrame: 4th week
measure: Goniometry
timeFrame: 4th week
Secondary outcomes:
measure: Numeric pain rating scale
timeFrame: 4th week
Other outcomes:
Locations:
city: Sialkot
country: Pakistan
facility: Sumaira Nawaz
state: Sialkot,Punjab,Pakistan
Study officials:
affiliation: Study Principal Investigator
name: Muhammad Sanaullah, MS
role: PRINCIPAL_INVESTIGATOR
References:
citation: Goodridge JP. Muscle energy technique: definition, explanation, methods of procedure. J Am Osteopath Assoc. 1981 Dec;81(4):249-54. No abstract available.
citation: Campbell SM, Winkelmann RR, Walkowski S. Osteopathic manipulative treatment: novel application to dermatological disease. J Clin Aesthet Dermatol. 2012 Oct;5(10):24-32.
citation: Jain TK, Sharma NK. The effectiveness of physiotherapeutic interventions in treatment of frozen shoulder/adhesive capsulitis: a systematic review. J Back Musculoskelet Rehabil. 2014;27(3):247-73. doi: 10.3233/BMR-130443.
citation: Yeganeh Lari A, Okhovatian F, Naimi Ss, Baghban AA. The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females. Man Ther. 2016 Feb;21:204-9. doi: 10.1016/j.math.2015.08.004. Epub 2015 Aug 14.
citation: Jones S, Hanchard N, Hamilton S, Rangan A. A qualitative study of patients' perceptions and priorities when living with primary frozen shoulder. BMJ Open. 2013 Sep 26;3(9):e003452. doi: 10.1136/bmjopen-2013-003452.
citation: Solomonow M, Krogsgaard M. Sensorimotor control of knee stability. A review. Scand J Med Sci Sports. 2001 Apr;11(2):64-80. doi: 10.1034/j.1600-0838.2001.011002064.x.
citation: Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H, Kang L, Yao L, Huang M, Wang H, Wang G, Liu Z, Hu S. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020 Mar 2;3(3):e203976. doi: 10.1001/jamanetworkopen.2020.3976.
citation: Doner G, Guven Z, Atalay A, Celiker R. Evalution of Mulligan's technique for adhesive capsulitis of the shoulder. J Rehabil Med. 2013 Jan;45(1):87-91. doi: 10.2340/16501977-1064.
citation: Nicholson GG. The effects of passive joint mobilization on pain and hypomobility associated with adhesive capsulitis of the shoulder. J Orthop Sports Phys Ther. 1985;6(4):238-46. doi: 10.2519/jospt.1985.6.4.238.