Additional Effects of Thoracic Spine Mobilization Combined With Glenohumeral Joint Mobilization on Pain, Range of Motion, and Functional Disability in Adhesive Capsulitis
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 34
- 试验地点
- 1
- 主要终点
- Pain Intensity
研究概览
简要总结
Adhesive capsulitis is a debilitating shoulder condition characterized by pain, restricted range of motion (ROM), and significant functional limitations. Conventional treatment primarily targets the glenohumeral joint, often neglecting the role of regional interdependence, particularly the thoracic spine's influence on shoulder mobility. Emerging evidence suggests that thoracic spine mobility plays a crucial role in optimizing shoulder mechanics, yet its therapeutic application in adhesive capsulitis remains underexplored. This study aims to investigate the additional effects of thoracic spine mobilization combined with glenohumeral joint mobilization, providing a more comprehensive rehabilitation approach to enhance pain relief, ROM, and functional outcomes.
A randomized controlled trial (RCT) will be conducted over one year at the Rehabilitation Department of Fauji Foundation Hospital (FFH) after obtaining ethical approval. Participants diagnosed with adhesive capsulitis will be selected through non-probability purposive sampling based on predefined inclusion and exclusion criteria. Subjects will be randomly assigned to either the experimental group receiving thoracic spine mobilization alongside glenohumeral joint mobilization or the control group receiving glenohumeral joint mobilization alone. Randomization will be conducted using the coin toss method and block randomization to ensure balanced subject distribution.
Outcome measures include the Numeric Pain Rating Scale (NPRS) for pain assessment, the Shoulder Pain and Disability Index (SPADI) for functional disability evaluation, and a goniometer for ROM measurement. Baseline and post-treatment scores will be statistically analyzed using SPSS to determine intervention effectiveness. By integrating thoracic spine mobilization into standard treatment, this study seeks to refine clinical rehabilitation protocols, improve functional recovery, and enhance patient outcomes. Findings may contribute to evidence-based practice, supporting the inclusion of thoracic spine mobilization in treatment guidelines for adhesive capsulitis.
详细描述
Adhesive capsulitis, widely known as frozen shoulder, is a progressive musculoskeletal condition characterized by shoulder pain, restricted range of motion (ROM), and marked functional limitations. Traditional treatment approaches have largely focused on mobilization techniques directed at the glenohumeral joint, aiming to reduce capsular tightness and restore movement. While this is effective to some degree, it does not fully address the concept of regional interdependence, where dysfunction in adjacent regions, particularly the thoracic spine, may influence shoulder function. The thoracic spine plays a vital role in maintaining optimal shoulder kinematics by supporting scapular positioning, facilitating overhead motion, and reducing compensatory stress on the glenohumeral joint. Stiffness or hypomobility in this region may therefore perpetuate pain and mechanical restriction in adhesive capsulitis. Treatment strategies that combine glenohumeral joint mobilization with thoracic spine mobilization have the potential to provide superior outcomes compared to conventional therapy alone. Thoracic mobilization techniques, including central and unilateral posterior-anterior glides, enhance spinal extension and rotation, indirectly improving scapular mobility and shoulder elevation. When paired with targeted glenohumeral mobilizations such as anterior, posterior, and inferior glides, patients may experience greater improvements in pain relief, ROM, and functional ability. These three variables-pain, ROM, and functional disability-are critical in determining treatment effectiveness. By incorporating thoracic mobilization into standard rehabilitation, clinicians may adopt a more holistic approach that enhances recovery, promotes long-term function, and improves the quality of life for individuals with adhesive capsulitis.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
盲法说明
no masking
入排标准
- 年龄范围
- 40 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •• Both male and female patients with a primary complaint of unilateral or bilateral shoulder pain
- •Pain has persisted for at least 3 to 4 months
- •Decreased shoulder ROM observed, including external shoulder rotation, abduction, internal rotation, and flexion
- •Age range between 40 to 65 years
- •Diagnosed with stage 2nd or 3rd of the disease.
排除标准
- •• Patients if they had any shoulder pain resulting from systematic disease such as Rheumatoid Arthritis (morning stiffness > 1 hour, multiple small joints pain/swelling) Infection, Tumors, and conditions like myelopathy (Hoffman's sign).
- •Recent shoulder joint fracture/ trauma.
- •Thoracic Outlet Syndrome (Roos test).
- •The presence of Cervical radiculopathy (Spurling's test)
研究组 & 干预措施
Thoracic spine mobilization with Glenohumeral joint mobilization
Participant receive Thoracic spine mobilization with Glenohumeral joint mobilization to enhance shoulder mechanics and outcomes
干预措施: Thoracic spine mobilization with Glenohumeral joint mobilization (Procedure)
Glenohumeral joint mobilization
Participant receive Glenohumeral joint mobilization only to enhance shoulder mechanics and outcomes
干预措施: Glenohumeral joint mobilization only (Procedure)
结局指标
主要结局
Pain Intensity
时间窗: 4 weeks
Pain intensity will be checked by Numeric pain rating scale NPRS, where patient will rate pain from 0 to 10, 0 being no pain and 10 means worst pain.
Functional disability
时间窗: 4 weeks
Shoulder Pain and Disability Index (SPADI) used to assess functional disability and it is 13-question survey (5 pain, 8 disability) on a 0-100 scale, where 0 is best (no pain/difficulty) and 100 is worst (severe pain/complete disability), indicating higher scores mean greater impairment; it's interpreted by looking at general ranges (0-20 mild, 21-40 moderate, etc.) and tracking changes (a 10-20 point shift suggests clinical significance) to gauge treatment effectiveness.
Shoulder Range of Motion
时间窗: 4 weeks
Goniometer used to measure shoulder joint range of motion.
次要结局
未报告次要终点