Adhesive capsulitis is a prevalent condition characterized by pain and stiffness in shoulder joint and surrounding muscles shows decrease range and strength in patients with adhesive capsulitis. This study aims to determine the effect of mulligan mobilization with or without Niel Asher technique on pain, range of motion and disability in patients with adhesive capsulitis. This study will be a randomized controlled trial and will be conducted in Ibne-siena Hospital Multan and Multicare physiotherapy clinic. Non-probability convenience sampling will be used to collect the data. Sample size of subjects with age group between 40 to 60 years will be taken. Data will be collected from the patients having present complaint of adhesive capsulitis. Outcome measures used will be Numeric pain rating scale (NPRS) for shoulder pain and SPADI for shoulder disability and Universal Goniometer (GU) for Range of motion. An informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria. Subjects will be divided into two groups by random number generator table. Both the Groups will receive heating pad, TENS. Group A will receive Mulligan Mobilizations and Neil Asher technique, and Group B will receive Mulligan mobilization and Conventional Treatment. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 26.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
42
* Mulligan mobilization technique for shoulder external rotation and abduction as described by Mulligan. 3 sets of 10 repetitions with 1 minute rest between sets, 3 times a week for 4 weeks are performed * Niel Asher technique provided for 3 sessions a week for 4 weeks
* Modalities i.e. heating pad and TENS for ten Minutes * Postural correction exercises / Scapular retraction * Therapeutic Exercise : Codman' s, finger ladder, wand exercises * End Range Gleno-humeral joint stretching Both groups will come four times per week for a total of 4 weeks. Pre and post treatment values of both groups will be analyzed.
Ibne Siena hospital Multan.
Multan Khurd, Punjab Province, Pakistan
RECRUITINGNumerical Pain Rating Scale (NPRS)
Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates " no pain" and 10 indicates " worst pain" . NPRS have shown high test- retest reliability (r = 0.96 and 0.95, respectively)
Time frame: baseline and fourth week
Universal Goniometer (UG)
The range of motion will be measured using universal goniometer that has an inter-rater reliability (ICC2, 2 = 0.79 to 0.92) for shoulder.
Time frame: baseline and fourth week
Shoulder disability and shoulder Index SPADI
The Shoulder Pain and Disability Index (SPADI) is a self-administered questionnaire that consists of two dimensions, one for pain and the other for functional activities. The pain dimension consists of five questions regarding the severity of an individual's pain. Functional activities are assessed with eight questions designed to measure the degree of difficulty an individual has with various activities of daily living that require upper- extremity use. The SPADI takes 5 to 10 minutes for a patient to complete and is the only reliable and valid region-specific measure for the shoulder. The reliability coefficient is ICC \>0.89 for Shoulder.
Time frame: baseline and fourthweek
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