A comparative clinical effect of Agnikarma and Physiotherapy along with Dashmooladi Kwatha in the management of Avabahuka w.s.r. to Frozen Shoulder

The research study entitled “A comparative clinical effect of Agnikarma and Physiotherapy along with Dashmooladi Kwatha in the management of Avabahuka w.s.r. to Frozen Shoulder.†Was aimed to evaluate and compare the efficacy of Agnikarma and physiotherapyalongwith Dashmooladi Kwatha in themanagement of Avabahuka w.s.r. frozen shoulder. This trial was summarized in review of literature, including Ayurvedic literature and modern literature of Avabahuka (frozen shoulder) and literature of Agnikarma.

Drug review comprises classical narration of Dashmooladi Kwatha with Pharmacognostical and analytical study.

Clinical study stats the open labelled comparative clinical studyof 111 clinical cases of frozen shoulders divided into two groups according computer generated randomization chart. Total 168 cases were screened through out the study with shoulder joint pain, among which total 111 cases were frozen shoulder falling in the study criteria. 57 cases were excluded due to failure for enrollment in the study. Rest 111 cases were enrolled for the study, 11 cases were dropped out and 100 cases completed the course of treatment and follow up as mentioned in study In group A (n=55), frozen shoulder patients managed through 4 sittings of Samyaka Bindu Dagdha Agnikarma with red hot Panchadhatu shalaka at most tender point of affected shoulder in seven days interval and Dashmooladi kwatha 50 g orally at evening after meal advised for 28 days. In group B (n= 56), physiotherapy was advised two times a day for fifteen minutes in each session with Dashmooladi kwatha 50 g orally at evening after meal advised for 28 days. Among which 49 patients in group A while 51patients in group B completed the treatment and follow up as per protocol. 6 patients in group A and 5 patients in group B were dropped out from the study. All the cases were screened for essential haematology, urology, bio-chemical and radiological investigations prior their enrolment for the study.  The effect of the treatment was assessed on the basis of relief in Pain, stiffness, Muscle power, muscle wasting, sensory loss, disability of arm, shoulder and hand (DASH) Score where subjective criteria were assessed by VAS scale and gradation. Active ranges of movements (AROM), were considered as the objective parameters. The AROM namely flexion, extension, abduction, adduction, internal rotation & external rotations in abduction were recorded according to the actual values of goniometric readings. All the cases were followed up for 1 month. The observed results in the study were subjected to statistical calculation to derive final conclusion.

Discussion on study was made on demographic observations and clinical findings. Conclusion of clinical study suggest that both the groups treatment protocol have shown Highly significant effect in shoulder pain, stiffness, DASH Score, abduction, flexion, internal rotation, external rotation, ESR in managing the cases of frozen shoulder whereas Significant difference was observed in Extension through therapy in both the groups. Highly significant difference was observed in comparative effect of therapy in pain, stiffness, DASH score and internal rotation whereas significant difference was noted in abduction. Non-significant difference was observed in comparative effects of therapy in relieving restricted flexion, extension, external rotation, ESR. Finally, study concluded that Agnikarma with Dashmooladi kwatha have better effect to manage shoulder pain as well as to restore joint function as compare to physiotherapy with Dashmooladi kwatha in the management of Avabahuka (frozen shoulder). Thus, it declares that, alternative hypothesis is accepted and null hypothesis is rejected i.e., Agnikarma along with Dashmooladi Kwatha ismore effective thanphysiotherapy along with Dashmooladi Kwatha in the management of Avabahuka w.s.r. tofrozen shoulder.