Effect of Scapular Mobilization with Movement (MWM) on shoulder dysfunction in adhesive capsulitis- A randomized controlled trial

MWM is associated with improvement in pain, range of motion, and function in patients with a range of shoulder musculoskeletal disorders and the effects are clinically significant. Scapular involvement in shoulder function is essential. Most arm functions involve scapular movement. Abnormal scapular movement has been associated with shoulder instability and shoulder impingement syndrome. There is substantial evidence indicating scapular kinematic abnormalities in individuals with shoulder pain. Research has shown that mobility deficits of FS affected not only the glenohumeral but also the scapulothoracic articulation. However, manual therapy techniques have primarily focused on mobilizing the glenohumeral joint in patients with frozen shoulder. Mobilization with movement is a specific form of manual therapy that is gaining increasing popularity, with several studies showing its benefit for a range of shoulder conditions. MWM involves applying a sustained gliding force (the passive mobilization component) while the patient concurrently performs an active movement , the active movement component. When MWM is precisely indicated, it has been shown to improve painful movement and immediately enhance function. As such, MWM differs from passive manual therapy, which is based on a test treat retest approach. There are very few studies examining the effectiveness of scapular mobilization in relation to shoulder joint pain, disability, and range of motion, and these studies have primarily involved passive mobilization.  We hypothesize that scapular MWM given over a period of 4 weeks along with glenohumeral MWM would result in improvement in range of motion , reduce pain and improve scapular kinematics by improving motor control strategy employed by the central nervous system when the glide is successfully applied.