Muscle Energy Technique With Or Without First Rib Mobilization In Adhesive Capsulitis

NCT ID: NCT05655611

Last Updated: 2023-03-16

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-10-10
• Study Completion Date: 2023-03-07

Brief Summary

This study will be a randomized control trial. Study will be conducted in 40 patients in the age range 40-70 years, which will be selected by using non proability convenient sampling technique. Subjects will be divided in 2 groups. Group A will receive first rib mobilization along with METS and conventional treatment, group B will receive METS and conventional physical therapy treatment only. Treatment will be given thrice per week for 3 weeks. Data will be collected pre and post treatment, for data collection numeric pain rating scale, shoulder pain and disability index (SPADI) will be used. Joint range of motion will be measured using goniometer. After collection data from defined study setting, data will be entered and analyzed at Riphah International University, Lahore.

Detailed Description

Adhesive capsulitis, also known as "frozen shoulder," is a common condition of the shoulder defined as a pathologic process in which contracture of the gleno-humeral capsule is a hallmark. Clinically, it presents as pain, stiffness, and dysfunction of the affected shoulder. Adhesive capsulitis is thought to afflict between 2 and 5% of the general population, with women affected more frequently than men. Individuals of middle age are most often affected, typically during the 5th to 7th decades of life.

Muscle energy techniques is a manual therapy that uses the gentle muscle contractions to relax and lengthen muscles and normalize joint motion. It is a class of soft tissue osteopathic manipulation consisting of isometric contraction designed to improve musculoskeletal function and reduce pain. The application of MET relaxes and improves biomechanics and result in improving functional ability.

Although conventional physical therapy treatment are used to treat frozen shoulder and effectiveness of muscle energy technique is proven, but the effect of first rib mobilization and MET has not been studied.

Conditions

Adhesive Capsulitis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

first rib mobilization

To perform the first rib mobilization, the patient remained lying supine with the head in the examiner's right hand. Examiner then palpated the left first rib and passively side-bended the patient's head to the left to relieve any muscular tension on the first rib. Patient was then asked to take a deep breath in and out. During exhalation, the examiner applied pressure to depress the first rib, holding it in place at the end of the exhalation. Then, holding the first rib in place, the patient was asked to inhale and exhale deeply again. The examiner continued applying pressure to hold the first rib in a position of relative depression during inhalation, and further depressed the first rib as able during exhalation. This process was repeated three times in two sets, for a total of six first rib depression mobilizations

Group Type: EXPERIMENTAL

first rib mobilization

Intervention Type: OTHER

To perform the first rib mobilization, the patient remained lying supine with the head in the examiner's right hand. Examiner then palpated the left first rib and passively side-bended the patient's head to the left to relieve any muscular tension on the first rib. Patient was then asked to take a deep breath in and out. During exhalation, the examiner applied pressure to depress the first rib, holding it in place at the end of the exhalation. Then, holding the first rib in place, the patient was asked to inhale and exhale deeply again. The examiner continued applying pressure to hold the first rib in a position of relative depression during inhalation, and further depressed the first rib as able during exhalation. This process was repeated three times in two sets, for a total of six first rib depression mobilizations.

muscle energy technique

All the patients will receive conventional physical therapy treatment and muscle energy techniques for shoulder flexion, abduction, internal and external rotation. Muscle energy technique was applied for five repetitions per set, five sets per session, one session per day, three days a week for three weeks with each repetition maintained for the duration of 7-10 seconds

Group Type: ACTIVE_COMPARATOR

muscle energy technique

Intervention Type: OTHER

Muscle energy technique for glenohumeral joint restricted abduction-The therapist stood in front of the patient, then placed one hand over the top of the subject's involved shoulder. The therapist cups the glenohumeral joint to palpate for motion and the subjects are directed to press the elbow towards their body. Muscle energy technique was applied for five repetitions per set, five sets per session, one session per day, three days a week for three weeks with each repetition maintained for the duration of 7-1 seconds.

Interventions

first rib mobilization

To perform the first rib mobilization, the patient remained lying supine with the head in the examiner's right hand. Examiner then palpated the left first rib and passively side-bended the patient's head to the left to relieve any muscular tension on the first rib. Patient was then asked to take a deep breath in and out. During exhalation, the examiner applied pressure to depress the first rib, holding it in place at the end of the exhalation. Then, holding the first rib in place, the patient was asked to inhale and exhale deeply again. The examiner continued applying pressure to hold the first rib in a position of relative depression during inhalation, and further depressed the first rib as able during exhalation. This process was repeated three times in two sets, for a total of six first rib depression mobilizations.

Intervention Type: OTHER

muscle energy technique

Muscle energy technique for glenohumeral joint restricted abduction-The therapist stood in front of the patient, then placed one hand over the top of the subject's involved shoulder. The therapist cups the glenohumeral joint to palpate for motion and the subjects are directed to press the elbow towards their body. Muscle energy technique was applied for five repetitions per set, five sets per session, one session per day, three days a week for three weeks with each repetition maintained for the duration of 7-1 seconds.

Intervention Type: OTHER

Other Intervention Names

first rib maitland mobilization; muscle energy technique for shoulder

Eligibility Criteria

Inclusion Criteria

• Age between 40-70 years
• Gender (both male and female)
• Subjects with adhesive capsulitis stage (II and III)

Exclusion Criteria

• Previous surgery on affected shoulder
• Recent trauma to shoulder
• fracture

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Muhammad Sanaullah, MS

Role: PRINCIPAL_INVESTIGATOR

Study Principal Investigator

Locations

Rabia welfare hospital

Lahore, Punjab Province, Pakistan

Countries

Pakistan

Other Identifiers

REC/RCR&AH/21/0130/SIDRA

Identifier Type: -

Identifier Source: org_study_id