Effects of Spencer Technique Following Hydrodilation in Patients With Adhesive Capsulitis

Adhesive Capsulitis is a common Musculoskeletal disorder characterized by pain and progressive joint restriction in capsular pattern. Adhesive capsulitis can be managed by both conservative and non conservative treatment. The Spencer technique and hydrodilation are two treatment approaches used to restore range of motion in adhesive capsulitis.

The Spencer technique is a form of physical therapy that involves joint mobilizations and manual stretching exercises. It aims to improve shoulder mobility and reduce pain by addressing the tightness and stiffness in the shoulder capsule and surrounding tissues.

Hydrodilation, on the other hand, is a procedure where a saline solution is injected into the shoulder joint to distend the capsule. This distention helps stretch the tight tissues and break up adhesions, facilitating improved range of motion.

Study Overview

• Status: Recruiting
• Conditions: Adhesive Capsulitis
• Intervention / Treatment: Procedure: Hydro dilation; Procedure: Spencer muscle energy technique; Procedure: Passive Stretching

Detailed Description

Adhesive capsulitis, also subsequently known as Frozen shoulder is a musculoskeletal disorder characterized by painful and progressive joint restriction in capsular pattern. It has a prevalence of 2 to 5% in general population and the incidence is more in females mostly aged 40 to 60 years mostly suffering from Diabetes Mellitus. Adhesive Capsulitis can be classified into three phases; Freezing (painful), Frozen (stiffening) and Thawing (resolution phase). The treatment protocol is planned such to improve the range of motion and reduce pain. Various treatment regimes are followed for treatment of adhesive capsulitis, either it be in medical field, physical therapy or in worst cases surgical treatments too.

Hydrodilation, a medical procedure which involves injecting a fluid (mainly normal saline) into the joint space which expands the space breaking up scar tissue and loosening the joint. This method is being widely used in isolation or in combination with other methods to treat Adhesive capsulitis.

Spencer technique on another hand is a physical therapy technique which in isolation or in conjunction with other treatments is used to treat patients with adhesive capsulitis. Spencer muscle energy technique is a seven 7 step procedure which consists of shoulder extension with elbow flexed, shoulder flexion with elbow flexed, circumduction with compression, circumduction with traction, Abduction then adduction with external rotation and glenohumeral pump.

Hence the current study will investigate the effects of Spencer technique following hydrodilation in patients with Adhesive Capsulitis.

The study includes subjects with unilateral adhesive capsulitis, 40-60 years of age both male and female and have undergone Hydrodilation. The selction of subjects will be using non probability purposive sampling technique. Participants will be randomized using sealed envelope method and allocated to one of two groups.

The data collection tool for pain is VAS, for ROM is Goniometer and for disability is SPADI.

The time duration for treatment protocol is total of 12 sessions, 3 sessions per week. Exercise is done 3 to 5 times with rest periods.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Javeria Ilyas, MS-MSKPT*; Phone Number: +923335888256; Email: javeria.ilyas95@gmail.com

Study Locations

• Pakistan
  • Punjab
    • Rawalpindi, Punjab, Pakistan, 46000
      • Recruiting
      • Foundation University College of Physical Therapy
      • Contact: Furqan Yaqoob, PhD*; Phone Number: +923465333101; Email: furqan.yaqoob@fui.edu.pk

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patients with diagnosed unilateral Adhesive Capsulitis and have undergone Hydrodilation. --Includes both genders
• Age 40 to 60 years. Exclusion Criteria
• Population who have recently undergone major shoulder injury or surgery, had fracture or open wound or there is reduction of Glen humeral ROM due to any other cause other than Adhesive Capsulitis

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Group A (Hydrodilation+Spencer Technique ); Patients in this group will be followed by Spencer Technique after Hydrodilation for the duration of 4 weeks which includes 12 sessions in total. Spencer muscle energy technique is a seven 7 step procedure which consists of shoulder extension with elbow flexed, shoulder flexion with elbow flexed, circumduction with compression, circumduction with traction, Abduction then adduction with external rotation and glenohumeral pump. Following the complete action, patients will be encouraged to use their muscles for 3 to 5 seconds against little resistance provided by the therapist	Procedure: Hydro dilation; The hydro dilation injections comprises of Depomedrol 80mg and normal saline 0.9%. It is performed under fluoroscopic guidance by the orthopedic surgeon.; Procedure: Spencer muscle energy technique; Spencer muscle energy technique is a seven 7 step procedure which consists of shoulder extension with elbow flexed, shoulder flexion with elbow flexed, circumduction with compression, circumduction with traction, Abduction then adduction with external rotation and glenohumeral pump. Following the complete action, patients will be encouraged to use their muscles for 3 to 5 seconds against little resistance provided by the therapist
Experimental: Group B (Hydro dilation+ Passive Stretching); This group will undergo Passive Stretching followed by Hydrodilation. The low intensity stretches will be given in supine for all the movements ie Flexion ,Abduction , Internal Rotation and External Rotation for 5 repititions with 30 sec hold. (7)	Procedure: Hydro dilation; The hydro dilation injections comprises of Depomedrol 80mg and normal saline 0.9%. It is performed under fluoroscopic guidance by the orthopedic surgeon.; Procedure: Passive Stretching; The low intensity stretches will be given in supine for all the movements ie Flexion ,Abduction , Internal Rotation and External Rotation for 5 repititions with 30 sec hold.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Shoulder ROM	Range of Motion will be measured using the universal Goniometer which is 0 to 180 degree for half circle model or 0 to 360 degree for full circle models.	4 weeks
Pain Intensity	Pain will be assessed using Visual Analog scale which is 0-100 item scale.	04 Weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Shoulder Disability	Shoulder Disability will be assessed using shoulder pain and disability index.	4 weeks

Collaborators and Investigators

• Sponsor: Foundation University Islamabad

Study record dates

Study Major Dates

• Study Start (Actual): July 20, 2024
• Primary Completion (Actual): October 1, 2024
• Study Completion (Estimated): October 31, 2024

Study Registration Dates

• First Submitted: October 30, 2024
• First Submitted That Met QC Criteria: October 30, 2024
• First Posted (Actual): October 31, 2024

Study Record Updates

• Last Update Posted (Actual): October 31, 2024
• Last Update Submitted That Met QC Criteria: October 30, 2024
• Last Verified: October 1, 2024

More Information

Terms related to this study

• Keywords: Hydrodilation, spencer technique, pain, functional disability, range of motion
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Joint Diseases; Bursitis
• Other Study ID Numbers: FUI/CTR/2024/47

Drug and device information, study documents

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