Spencer's Muscle Energy Technique Along With Strain Counter Strain in Adhesive Capsulitis.

NCT04822324 | Completed

• 1 other identifier: REC/00762 Aimen Iftikhar
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Numerous Physiotherapy techniques have been found to be beneficial but there is no consensus on the best treatment approach for speeding up rehabilitation process and rejuvenating functional capacity in patients suffering from Adhesive capsulitis. Spencer Muscle energy technique is found to be effective in treatment of shoulder pathologies. It increases pain free range of motion through stretching the tissues, enhancing lymphatic flow and increasing the joint circulation where as Strain Counter Strain is a technique derived from positional release therapy which uses a pain monitor (trigger points) to find the position of the pain when it is no longer felt at the monitoring point. The purpose of this study is to determine the effects of Spencer Muscle energy technique with and without the employment of Strain Counter Strain on pain, Range of motion and disability in Adhesive capsulitis.

Conditions

Adhesive Capsulitis

Keywords

adhesive capsulitis; spencer muscle energy; strain counterstrain

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale (NPRS):

  Numeric Pain Rating Scale (NPRS) is a11-point scale. The scale is anchored on the left with the phrase ''no pain'' and on the right with the phrase ''worst imaginable pain.'' Patients rate their current level of pain and their worst and least amount of pain in the last 24 hours.

  4 weeks

• Shoulder Pain and Disability Index (SPADI):

  Functional Disability was measured using Shoulder pain and Disability Index (SPADI). It was developed to measure the pain and disability associated with shoulder pathology. SPADI is a self administered index consisting of 13 items divided into two subscales i.e. pain and disability.

  4 weeks

• Shoulder ROM

  Shoulder ROM was measured using Goniometer. It is an instrument which measures the available range of motion at a joint. There are different types of goniometers. The type that is most used is the universal standard goniometer, which is either made with plastic or metal tool. It consists of a stationary arm, a movable arm and a fulcrum. It is a reliable tool for measuring shoulder ROM's in degree.

  4 Weeks

Study Arms (2)

Spencer Muscle energy technique with conventional Physiotherapy

EXPERIMENTAL

1. shoulder extension with elbow flexion. 2. shoulder flexion with elbow extension. 3. circumduction with compression 4. circumduction with distraction 5. shoulder abduction and internal rotation with elbow flexion. 6. shoulder adduction and external rotation with elbow flexion 7. stretching tissue and pumping fluids with the arm extended: therapist interlocks his fingertips over the deltoid muscle, patient's hand was placed over the therapist shoulder, and the therapist slowly moved the arm away from the shoulder and released. During all the movements patient is asked to use their muscle energy against the slight resistance offered by the therapist for 6-8 sec. conventional therapy Joint mobilization Exercise therapy: Self stretching and strengthening exercises

Other: Spencer Muscle energy technique with conventional Physiotherapy

Strain counter strain along with conventional Physiotherapy and Spencer Muscle energy technique

ACTIVE COMPARATOR

Palpate surrounding and opposing tissues to locate tender point for both shoulder abduction and external rotation. Use one or two finger pads to monitor fasciculation and TP. Fine-tune position with rotation. Hold the POC (position of comfort) until fasciculation decreases significantly or ceases. Average positions hold time while pressure is 90 s to 3 min. Transient periods of brief tingling, numbness, and temperature changes might occur. Release tissue or joint slowly and reassess.

Other: Strain counter strain along with conventional Physiotherapy and Spencer Muscle energy technique

Interventions

Spencer Muscle energy technique with conventional Physiotherapy OTHER

shoulder extension with elbow flexion. shoulder flexion with elbow extension. circumduction with compression circumduction with distraction shoulder abduction and internal rotation with elbow flexion. shoulder adduction and external rotation with elbow flexion stretching tissue and pumping fluids with the arm extended: therapist interlocks his fingertips over the deltoid muscle, patient's hand was placed over the therapist shoulder, and the therapist slowly moved the arm away from the shoulder and released. During all the movements patient is asked to use their muscle energy against the slight resistance offered by the therapist for 6-8 sec. conventional therapy Joint mobilization Exercise therapy: Self stretching and strengthening exercises

Spencer Muscle energy technique with conventional Physiotherapy

Strain counter strain along with conventional Physiotherapy and Spencer Muscle energy technique OTHER

Palpate surrounding and opposing tissues to locate tender point for both shoulder abduction and external rotation. Use one or two finger pads to monitor fasciculation and TP. Fine-tune position with rotation. Hold the POC (position of comfort) until fasciculation decreases significantly or ceases. Average positions hold time while pressure is 90 s to 3 min. Transient periods of brief tingling, numbness, and temperature changes might occur. Release tissue or joint slowly and reassess.

Strain counter strain along with conventional Physiotherapy and Spencer Muscle energy technique

Eligibility Criteria

• Age: 35 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients clinically diagnosed with unilateral adhesive capsulitis.
• Patients who had restricted ROM (loss of 25% or greater relative to non-
• involved shoulder in one or multidirectional).
• Stage 2 and 3 of frozen shoulder.
• Diabetic patients diagnosed with frozen shoulder.

You may not qualify if:

• A history of major shoulder injury or surgery.
• Other disorders possibly influencing existing shoulder symptoms e.g. cervical neuropathy.
• Paralysis or neurological changes of the affected upper limb.
• Fractures or open wounds;
• Degenerative, inflammatory, or infectious arthritis;
• History of intra-articular injection pain treatment.
• History of osteoporosis or malignancies in shoulder region

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Pakistan Railway General Hospital

Rawalpindi, Punjab Province, 46000, Pakistan

Location

Related Publications (10)

• Le HV, Lee SJ, Nazarian A, Rodriguez EK. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow. 2017 Apr;9(2):75-84. doi: 10.1177/1758573216676786. Epub 2016 Nov 7.

  PMID: 28405218 BACKGROUND

• Manske RC, Prohaska D. Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med. 2008 Dec;1(3-4):180-9. doi: 10.1007/s12178-008-9031-6.

  PMID: 19468904 BACKGROUND

• D'Orsi GM, Via AG, Frizziero A, Oliva F. Treatment of adhesive capsulitis: a review. Muscles Ligaments Tendons J. 2012 Sep 10;2(2):70-8. Print 2012 Apr.

  PMID: 23738277 BACKGROUND

• Inayat F, Ali NS, Shahid H, Younus F. Prevalence and Determinants of Frozen Shoulder in Patients with Diabetes: A Single Center Experience from Pakistan. Cureus. 2017 Aug 6;9(8):e1544. doi: 10.7759/cureus.1544.

  PMID: 29018641 BACKGROUND

• Doner G, Guven Z, Atalay A, Celiker R. Evalution of Mulligan's technique for adhesive capsulitis of the shoulder. J Rehabil Med. 2013 Jan;45(1):87-91. doi: 10.2340/16501977-1064.

  PMID: 23037929 BACKGROUND

• Patriquin DA. The evolution of osteopathic manipulative technique: the Spencer technique. J Am Osteopath Assoc. 1992 Sep;92(9):1134-6, 1139-46.

  PMID: 1429074 BACKGROUND

• Patel VD, Eapen C, Ceepee Z, Kamath R. Effect of muscle energy technique with and without strain-counterstrain technique in acute low back pain - A randomized clinical trial. Hong Kong Physiother J. 2018 Jun;38(1):41-51. doi: 10.1142/S1013702518500051. Epub 2018 Apr 4.

  PMID: 30930578 BACKGROUND

• Mintken PE, Glynn P, Cleland JA. Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain. J Shoulder Elbow Surg. 2009 Nov-Dec;18(6):920-6. doi: 10.1016/j.jse.2008.12.015. Epub 2009 Mar 17.

  PMID: 19297202 BACKGROUND

• Kolber MJ, Hanney WJ. The reliability and concurrent validity of shoulder mobility measurements using a digital inclinometer and goniometer: a technical report. Int J Sports Phys Ther. 2012 Jun;7(3):306-13.

  PMID: 22666645 BACKGROUND

• Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991 Dec;4(4):143-9.

  PMID: 11188601 BACKGROUND

MeSH Terms

Conditions

Bursitis

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Officials

• Maria Khalid, MSOMPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 22, 2021
• First Posted: March 30, 2021
• Study Start: September 1, 2020
• Primary Completion: January 30, 2021
• Study Completion: February 20, 2021
• Last Updated: December 17, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)