Comparison of Spencer's Muscle Energy Technique and Post-facilitation Stretch in Patients With Adhesive Capsulitis

Not Applicable

Completed

• Conditions: Frozen Shoulder

• Registration Number: NCT05811533
• Lead Sponsor: Riphah International University

Brief Summary

Adhesive capsulitis is one of the most common problems of the upper limb. Adhesive capsulitis (AC) and frozen shoulder syndrome (FSS) are two terms that have been used to describe a painful and stiff shoulder.

Conservative treatment includes transcutaneous electrical nerve stimulation (TENS), Ultrasound, LASER, Range of Motion, stretching and strengthening exercises, patient education, and home exercises. Manual therapy includes mobilization, Spencer's Muscle Energy Technique and Mobilization With Movement.

Detailed Description

The American Academy of Orthopedic Surgeons defines this condition as: "A condition of varying severity characterized by the gradual development of global limitation of active and passive shoulder motion where radiographic findings other than osteopenia are absent." Patients with frozen shoulder typically experience insidious shoulder stiffness, severe pain that usually worsens at night, and near-complete loss of passive and active external rotation of the shoulder.

Although spencer's Muscle Energy Technique is a very effective technique, still it was rarely used. It is a standardized series of steps of shoulder treatments with broad application in diagnosis, treatment, and prognosis developed by Spencer in 1961 and is a well-known osteopathic manipulative technique that focuses on mobilization of the glenohumeral and scapulothoracic joints. It is an articulatory technique in which passive, smooth, rhythmic motion of the shoulder joint is done by the therapist to stretch contracted muscles, ligaments, and capsule. Most of the force is applied at the end range of motion. This technique increases pain-free Range of Motion by stretching the tissues, enhancing lymphatic flow, and stimulating increased joint circulation.

On the other hand, "post-facilitation stretch (PFS)" is a muscle energy technique developed by Dr.Vladimir Janda to lengthen chronically shortened muscles that involves a maximal contraction of the muscle at mid-range with a rapid movement to maximal length followed by a 20-second static stretch. This technique is more aggressive than Post Isometric Relaxation and based on the concept of autogenic inhibition

Study Timeline

• Study First Submitted: 2023-03-31
• Study First Submitted QC: 2023-03-31
• Study Start: 2023-04-01
• Study First Posted: 2023-04-13
• Status Verified: 2023-07
• Primary Completion: 2023-07-10
• Study Completion: 2023-07-10
• Last Update Submitted: 2023-07-18
• Last Update Posted: 2023-07-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

• Patients with primary unilateral adhesive capsulitis
• Stage II and III adhesive capsulitis
• Patients with limited active and passive Range of Motion of the affected shoulder (globally loss of at least 50% compared to non-involved shoulder in one or more directions)
• Patients with controlled diabetes

Exclusion Criteria

• Patients with a positive history of trauma, fracture, or surgery of the cervical spine
• Corticosteroid injection in the affected shoulder in the preceding 4 weeks.
• Malignancy/Avascular Necrosis of shoulder
• Post-traumatic shoulder stiffness
• Thoracic outlet syndrome/neurological disorder
• Patients with cervical radiculopathy

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
SPADI (Shoulder Pain and Disability Index)	four weeks	The shoulder pain and disability index (SPADI) is also a reliable and valid clinimetric (Cronbach-α\>0.90), self-administered questionnaire used by orthopedics and physical therapists for proper assessment of shoulder related pain and disabilities in terms of functional outcomes in patients suffering from different types of the shoulder-related pathologies. It consists of 13 items with two domains; a subscale (5-item) that measures pain, and another subscale (8-item) that assesses disability. Each subscale is added and transformed into a score that ranges from 0 (less shoulder disability) to 100 (more shoulder dysfunction).
(Numeric Pain Rating Scale)	four weeks	The Numeric Pain Rating Scale (NPRS) measures the subjective intensity of pain. The NPRS is an eleven-point scale from 0 to 10. "0" = no pain and "10" = the most intense pain imaginable
Goniometer	four weeks	A goniometer is a device that measures an angle or permits the rotation of an object to a definite position. To measure the range of motion, doctors, osteopaths, physical therapists, or other health professionals most commonly use a goniometer, which is an instrument that measures angle motion at a joint

Trial Locations

Locations (1)

Railway General Hospital; 🇵🇰 Rawalpindi, Punjab, Pakistan