Effects of Scapular Proprioceptive Neuromuscular Facilitation on Pain and Range of Motion in Patients With Adhesive Capsulitis

The term ''frozen shoulder'' is defined as a clinical condition with restricted active and passive range of motion (ROM) in all directions, including flexion, abduction, and rotation.The objective of the study is to determine the effects of Scapular proprioceptive neuromuscular facilitation and conventional physical therapy among patients with adhesive capsulitis.The study will be a randomized controlled trial (single-blinded parallel study), consisting of 2 groups- interventional group A and interventional group B.Group A will be given conventional physical therapy and group B will be given conventional physical therapy alongwith scapular PNF.Scapular PNF exercises are not included in our routine PT treatment programs and there is limited literature related to the PNF techniques. These techniques help develop muscular strength and endurance, joint stability, mobility, neuromuscular control and coordination all of which are aimed at improving the overall functional ability of patients.

Study Overview

• Status: Active, not recruiting
• Conditions: Adhesive Capsulitis
• Intervention / Treatment: Procedure: Conventional Physical Therapy; Procedure: PNF techniques

• Study Type: Interventional
• Enrollment (Estimated): 32
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Federal
    • Islamabad, Federal, Pakistan, 46000
      • Foundation University Islamabad

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Cases diagnosed with adhesive capsulitis, both primary and secondary origin.
• Stage two and stage three of adhesive capsulitis.
• Unilateral adhesive capsulitis.
• Both males and females of the age group 40 years and above.

Exclusion Criteria:

• History of shoulder surgery or manipulation under anesthesia,
• Local corticosteroid injection administration to the affected shoulder within the last 3 months.
• Severe musculoskeletal, neurological and cardiovascular conditions.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Conventional PT Group; Conventional group will receive routine physical therapy including 10 ultrasound(1.5w/cm2 ,3 MHz continuous type, duration 10 minutes),hot packs (on affected region of shoulder for 10 minutes),shoulder ROM, stretching exercises, and joint mobilization five times per week for two weeks with 40 minutes duration of each session. Maitland mobilization will be given in supine position. · After giving glenohumeral joint distraction, caudal, dorsal, and ventral glides will be given at a rate of 2-3 oscillation/second for 1 to 2 minutes to patients. Grade I or II rhythmic oscillations will be applied in free range.	Procedure: Conventional Physical Therapy; group A will receive conventional physical therapy including 10 ultrasound(1.5w/cm2 ,3 MHz continuous type, duration 10 minutes),hot packs (on affected region of shoulder for 10 minutes),shoulder ROM, stretching exercises, and joint mobilization five times per week for two weeks with 40 minutes duration of each session. Maitland mobilization will be given in supine position. · After giving glenohumeral joint distraction, caudal, dorsal, and ventral glides will be given at a rate of 2-3 oscillation/second for 1 to 2 minutes to patients. Grade I or II rhythmic oscillations will be applied in free range.
Experimental: Scapular PNF + Conventional PT Group; This group will receive scapular PNF techniques along with routine physical therapy (same as above). In this group 20 repetitions of diagonal scapular pattern (anterior elevation and posterior depression, posterior elevation and anterior depression) with 20 seconds rest period will be given to subjects. PNF techniques of rhythmic initiation and repeated contractions will be used in all patterns, applied for 40 minutes.	Procedure: Conventional Physical Therapy; group A will receive conventional physical therapy including 10 ultrasound(1.5w/cm2 ,3 MHz continuous type, duration 10 minutes),hot packs (on affected region of shoulder for 10 minutes),shoulder ROM, stretching exercises, and joint mobilization five times per week for two weeks with 40 minutes duration of each session. Maitland mobilization will be given in supine position. · After giving glenohumeral joint distraction, caudal, dorsal, and ventral glides will be given at a rate of 2-3 oscillation/second for 1 to 2 minutes to patients. Grade I or II rhythmic oscillations will be applied in free range.; Procedure: PNF techniques; In this group 20 repetitions of diagonal scapular pattern (anterior elevation and posterior depression, posterior elevation and anterior depression) with 20 seconds rest period will be given to subjects. PNF techniques of rhythmic initiation and repeated contractions will be used in all patterns, applied for 40 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Shoulder Pain	Shoulder Pain will be measured on the basis of visual analogue scale of 0-100mm. A higher score signifies greater pain.	2 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Shoulder range of motion (ROM)	Shoulder range of motion (ROM) will be measured through goniometer. A higher score signifies greater range.	2 weeks
Scapular mobility	scapular mobility will be measured through lateral slide test (LSST)	2 weeks

Collaborators and Investigators

• Sponsor: Foundation University Islamabad
• Investigators: Principal Investigator: Maryum Fatima, Foundation University Islamabad

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2022
• Primary Completion (Estimated): June 15, 2023
• Study Completion (Estimated): July 1, 2023

Study Registration Dates

• First Submitted: May 25, 2023
• First Submitted That Met QC Criteria: June 2, 2023
• First Posted (Actual): June 5, 2023

Study Record Updates

• Last Update Posted (Actual): June 5, 2023
• Last Update Submitted That Met QC Criteria: June 2, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Joint Diseases; Musculoskeletal Diseases; Bursitis
• Other Study ID Numbers: FUI/CTR/2023/8

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No