This randomized control trial aims to compare the effect of myofascial release of subscapularis along with shoulder mobilization VS mobilization alone among patients with adhesive capsulitis. The study will be conducted at physiotherapy outpatient department (OPD) of Sindh Institute of physical medicine and rehabilitation, and Dow University Ojha Campus, Karachi. According to study criteria, 70 patients with sub-acute adhesive capsulitis will be selected through a non-randomized purposive sampling technique by a consultant physician. After taking informed consent, participants will be randomly divided into 2 groups through the sealed envelope method. Both the groups will receive conventional treatment while Group 1 will be given an additional treatment of myofascial release of subscapularis through ischemic compression technique. Total 6 treatment sessions will be provided and assessment will be done at baseline and end of the 6th session.
The sample size of 31 per group was determined using planning and specification software (PASS) version 15 software based on two independent sample t-test using 95%confidence interval and 80% power of the test. This sample was raised to 35 per group with 4 patients as drop out per group. Mean and standard deviation will be calculated for the quantitative variables while frequency and percentages will be calculated for qualitative variables. Inter-group comparison at baseline will be calculated using an independent sample t-test. The mean difference between both the techniques in terms of numeric pain rating scale (NPRS), range of motion (ROM), shoulder pain and disability index (SPADI), and pain pressure threshold(PPT) will be determined using Repeated measure 2-way ANOVA.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
70
It is the application of manual pressure over myofascial trigger point that induces ischemia and causes release of trigger points
It is the type of mobilization technique that uses passive accessory mobilization to reduce pain and stiffness and increasing range of motion
It is the technique use to increase flexibility and range of motion of short and hypomobile structures
It is the application of cold to provide analgesic effects
Sindh Institute Physical Medicine and Rehabilitation
Karachi, Sindh, Pakistan
RECRUITINGDow University Hospital Ojha Campus
Karachi, Sindh, Pakistan
RECRUITINGChange from baseline pain intensity on Numeric Pain Rating Scale in scores at 6th session (10 days)
It will be use to assess pain intensity. It will be administered by simply asking the intensity of pain experienced in last 24 hours. The response of 0 represent no pain rather the responses between 1-3, 4-6, and 7-9 represents mild, moderate, and severe pain respectively. While 10 is the worst possible pain ever experienced by the person
Time frame: At baseline and after 6 sessions (10 days)
Change from baseline joint range of motion on universal goniometer in degrees at 6th session (10 days)
It will be assessed by using standard universal goniometer and measured in degrees
Time frame: At baseline and after 6 sessions (10 days)
change from baseline shoulder disability on Shoulder pain and disability index in percentage at 6th session (10 days)
Shoulder pain and disability index is used to assess shoulder disability. It consist of 13 questions i .e. 5 to assess pain and 8 to assess disability. Results will be calculated in percentage and higher results indicate increased disability. lower the percentage better will be the outcome.
Time frame: At baseline and after 6 sessions (10 days)
Change from baseline pain pressure threshold on algometer in kilogram/centimeter2 at 6th session (10 days)
assessed through algometer which provide sustained pressure from 0.05Newton/second to 20 Newton/second. Results will be recorded in kilogram/centimeter2 and higher values indicate decrease sensitivity of myofascial trigger points
Time frame: At baseline and after 6 sessions (10 days)
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