Effect of Myofascial Release of Subscapularis Along With Shoulder Mobilization in Adhesive Capsulitis

NCT05325255 | Unknown

• 1 other identifier: UAbbasi
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 2

Brief Summary

This randomized control trial aims to compare the effect of myofascial release of subscapularis along with shoulder mobilization VS mobilization alone among patients with adhesive capsulitis. The study will be conducted at physiotherapy outpatient department (OPD) of Sindh Institute of physical medicine and rehabilitation, and Dow University Ojha Campus, Karachi. According to study criteria, 70 patients with sub-acute adhesive capsulitis will be selected through a non-randomized purposive sampling technique by a consultant physician. After taking informed consent, participants will be randomly divided into 2 groups through the sealed envelope method. Both the groups will receive conventional treatment while Group 1 will be given an additional treatment of myofascial release of subscapularis through ischemic compression technique. Total 6 treatment sessions will be provided and assessment will be done at baseline and end of the 6th session.

Conditions

Adhesive Capsulitis of Shoulder

Keywords

Adhesive capsulitis; Muscle stretching exercise; Myofascial trigger point; Range of motion; Pain

Outcome Measures

Primary Outcomes (4)

• Change from baseline pain intensity on Numeric Pain Rating Scale in scores at 6th session (10 days)

  It will be use to assess pain intensity. It will be administered by simply asking the intensity of pain experienced in last 24 hours. The response of 0 represent no pain rather the responses between 1-3, 4-6, and 7-9 represents mild, moderate, and severe pain respectively. While 10 is the worst possible pain ever experienced by the person

  At baseline and after 6 sessions (10 days)

• Change from baseline joint range of motion on universal goniometer in degrees at 6th session (10 days)

  It will be assessed by using standard universal goniometer and measured in degrees

  At baseline and after 6 sessions (10 days)

• change from baseline shoulder disability on Shoulder pain and disability index in percentage at 6th session (10 days)

  Shoulder pain and disability index is used to assess shoulder disability. It consist of 13 questions i .e. 5 to assess pain and 8 to assess disability. Results will be calculated in percentage and higher results indicate increased disability. lower the percentage better will be the outcome.

  At baseline and after 6 sessions (10 days)

• Change from baseline pain pressure threshold on algometer in kilogram/centimeter2 at 6th session (10 days)

  assessed through algometer which provide sustained pressure from 0.05Newton/second to 20 Newton/second. Results will be recorded in kilogram/centimeter2 and higher values indicate decrease sensitivity of myofascial trigger points

  At baseline and after 6 sessions (10 days)

Study Arms (2)

Maitland mobilization with myofascial trigger point release group

EXPERIMENTAL

Maitland technique: caudal, anteroposterior (AP), and posteroanterior (PA) glides 5 sets of 2-3 glides per second of Grade III and IV for 30 seconds with a rest interval of 30 second between sets. Ischemic Compression technique: on subscapularis trigger points for 90 secs thrice a week for 2 weeks. Stretching exercises in direction of abduction, external rotation (ER), internal rotation (IR), and flexion. 6 repetitions of each stretch for 10 seconds Cold pack for 20 mins

Other: Myofascial release of subscapularis; Other: Maitland mobilization; Other: Stretching exercises; Other: Cold pack

Maitland mobilization alone group

ACTIVE COMPARATOR

Maitland technique: caudal, anteroposterior (AP), and posteroanterior (PA) glides 5 sets of 2-3 glides per second of Grade III and IV for 30 seconds with a rest interval of 30 second between sets. Stretching exercises in direction of abduction, external rotation (ER), internal rotation (IR), and flexion. 6 repetitions of each stretch for 10 seconds Cold pack for 20 mins

Other: Maitland mobilization; Other: Stretching exercises; Other: Cold pack

Interventions

Myofascial release of subscapularis OTHER

It is the application of manual pressure over myofascial trigger point that induces ischemia and causes release of trigger points

Maitland mobilization with myofascial trigger point release group

Maitland mobilization OTHER

It is the type of mobilization technique that uses passive accessory mobilization to reduce pain and stiffness and increasing range of motion

Maitland mobilization alone group; Maitland mobilization with myofascial trigger point release group

Stretching exercises OTHER

It is the technique use to increase flexibility and range of motion of short and hypomobile structures

Maitland mobilization alone group; Maitland mobilization with myofascial trigger point release group

Cold pack OTHER

It is the application of cold to provide analgesic effects

Maitland mobilization alone group; Maitland mobilization with myofascial trigger point release group

Eligibility Criteria

• Age: 40 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients aged between 40-65 years
• Diagnosed with sub-acute adhesive capsulitis
• Pain range of 3 to 8 on NPRS
• SPADI score of \>40
• Presence of myofascial trigger point in subscapularis muscle

You may not qualify if:

• History of fracture
• Rheumatoid arthritis
• Shoulder osteoarthritis
• Any malignancy
• Shoulder dislocation
• Subacute adhesive capsulitis with impingement syndrome

Sponsors & Collaborators

• Dow University of Health Sciences: lead

Study Sites (2)

Sindh Institute Physical Medicine and Rehabilitation

Karachi, Sindh, 74200, Pakistan

RECRUITING

Dow University Hospital Ojha Campus

Karachi, Sindh, Pakistan

RECRUITING

MeSH Terms

Conditions

Bursitis; Pain

Interventions

Muscle Stretching Exercises

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Umama Abbasi, DPT

  Dow University of Health Sciences

  PRINCIPAL INVESTIGATOR

• Rabail R Soomro, PhD Scholar

  Sindh Institute of Physical Medicine and Rehabilitation

  STUDY DIRECTOR

• Aftab Ahmed Mirza Baig, MSAPT

  Sindh Institute of Physical Medicine and Rehabilitation

  STUDY DIRECTOR

Central Study Contacts

Umama Abbasi, DPT

CONTACT

+923122930340; umamaabbasi42@gmail.com

Aftab Ahmed Mirza Baig, MSAPT

CONTACT

+923002739920; ab.dptrm@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle Investigator

Study Record Dates

• First Submitted: March 28, 2022
• First Posted: April 13, 2022
• Study Start: April 26, 2022
• Primary Completion: April 30, 2023
• Study Completion: April 30, 2023
• Last Updated: February 16, 2023

Record last verified: 2023-02

Locations

PA (2)