Comparison of Spencer Technique and Gongs Mobilization in Patients With Phase ii Adhesive Capsulitis

NCT05347355 | Unknown

• 1 other identifier: REC/Lhr/22/0130 Nimra
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 2

Brief Summary

Adhesive capsulitis can be defined as insidious and progressive loss of both active and passive shoulder mobility in the glenohumeral joint presumably due to capsular contracture. It is associated with inflammation and stiffness of the capsule surrounding the glenohumeral joint, greatly restricting motion and causing chronic pain. The objective of this study is to compare the effects of spencer technique and gongs mobilization on pain, range of motion, disability, and scapular symmetry in patients with phase II adhesive capsulitis. This study will be a Randomized Clinical trial involving 48 patients both males and females aged 40 to 60 years clinically diagnosed cases of phase II adhesive capsulitis. Patients will be randomly assigned into two groups using consecutive sampling technique. Group A will be treated with conventional treatment and spencer technique whereas Group B will be treated with conventional treatment and gongs mobilization. Numeric Pain Rating Scale will be used to measure pain of patients. Shoulder Pain and Disability Index score will be used to ask some questions related to patient's symptoms and disability. Lateral scapular slide test will be used to measure scapular symmetry and universal goniometer will be used to measure range of motion of shoulder joint. Each session will be repeated for 40 minutes thrice a week. All participants of the study will fill the Numeric Pain Rating Scale and Shoulder Pain and Disability Index score on day 1 as pretreatment values and at the end of 4th week as post treatment values respectively. The collected data will be analyzed on SPSS - 25. Key words: Adhesive, scapula, mobilizations, glenohumeral joint, pain

Conditions

Adhesive Capsulitis

Keywords

Adhesive; scapula; mobilization; glenohumeral joint

Outcome Measures

Primary Outcomes (4)

• NUMERIC PAIN RATING SCALE

  Numeric pain rating scale is a measurement of pain intensity in adults. The NPRS is a segmented numeric version of visual analogue scale (VAS) in which respondent select a whole number (0 to 10) that best reflects the intensity of pain. Scores range from 0 to 10

  4 weeks

• SHOULDER PAIN AND DISABILITY INDEX (SPADI)

  SPADI 5 is a self-administered, shoulder-specific, fixed object index composed of 13 items divided into two subscales: pain (five items) and impairment (eight items). Responses to each item were recorded on a 10 point Likert scale, where 0= no pain or no difficulty and 10 =worst imaginable pain or so difficult it required help for the pain and disability items, respectively. The SPADI score is calculated by summing and then averaging the items of the two subscales to give a score out of 100 (higher scores reflects more pain/disability). The SPADI has acceptable test-retest reliability (intraclass correlation coefficients of 0.91 and 0.65 (95% CI, 0.42 to 0.8) in surgical and primary care populations respectively) and acceptable responsiveness

  4 weeks

• LATERAL SCAPULAR SLIDE TEST

  Three positions are measured with the LSST designed by Kibler, is used to assess the scapular asymmetry under varying loads. To maintain a consistent posture during the various test positions, participants are instructed to fix their eyes on an object in the examination area. First test position, the participant is instructed to keep the arms relaxed at his/her sides, the most inferior aspect of the inferior angle of the scapula and the closest spinous process in the same horizontal plane is identified through palpation and marked. The distance between the 2 reference points is measured bilaterally with the help of a tape measure. This procedure is repeated for test position 2 (participant actively placed both hands on the ipsilateral hips, and consequently the humerus is positioned in medial rotation at -45° of abduction in the coronal plane) and test position 3 (the participant is instructed to maintain thumbs down position

  4 weeks

• UNIVERSAL GONIOMETER

  Active and passive abduction (in the frontal plane) and external rotation (with the arm at 0 degrees of abduction) ROM measured with a conventional goniometer as per the guidelines given by the American Academy of Orthopedic Surgeons. Goniometric measurements are highly reliable provided measurements are conducted by same therapist (test-retest reliability: 0.94-0.98)

  4 weeks

Study Arms (2)

Spencer technique along with conventional treatment

EXPERIMENTAL

Other: Spencer technique along with conventional treatment

Gongs Mobilization along with conventional treatment

EXPERIMENTAL

Other: Gongs Mobilization along with conventional treatment

Interventions

Spencer technique along with conventional treatment OTHER

Subjects in this group will receive conventional exercises and 7 stages of Spencer technique: (A) extension, (B) flexion, (C) circumduction with compression, (D) circumduction with traction, (E) abduction, (F) internal rotation, (G) lymphatic pump. Spencer technique will be used to increase range of motion of the glenohumeral joint. The patient will be positioned lying on the side with the affected shoulder above. The therapist will stabilize the shoulder girdle with the proximal hand and the distal hand will provide force into the restrictive barrier of shoulder in 7 different movements. These will be shoulder extension, circumduction with distraction, abduction, adduction with internal rotation and glenohumeral pump. During all the movements, patient will be asked to use muscle energy against the slight resistance offered by the therapist for 3-5 seconds. The exercise will be repeated 3-5 times with rest intervals over 3 sessions per week on alternate days for 4 weeks.

Spencer technique along with conventional treatment

Gongs Mobilization along with conventional treatment OTHER

The Gong's mobilization can be done either in high sitting or in side-lying position with the affected shoulder upward. The subject's shoulder will be abducted at 90° so that the humerus will be maintained at vertical position. The elbow joint will be flexed and maintained at 90°; the therapist will maintain this position by placing his/her hand below the subject's elbow. The humeral head will be pressed from anterior to posterior direction with the other hand. The therapist will hold the vertical axis of the humerus by maintaining the shoulder in abduction and the elbow in 90°. The therapist will raise his own body by slightly pulling on the anterior capsule and this pull will be maintained for 10-15 seconds and then relax for five seconds and will be performed for about two to three minutes. At this moment the subject will be asked to perform shoulder abduction with no external rotation, while elbow flexion will be maintained throughout.

Gongs Mobilization along with conventional treatment

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients of age group between 40-60 years.
• Both Males and Females.
• Clinically diagnosed patients of phase II adhesive capsulitis will be included.
• Adhesive Capsulitis subjects with limited Range of motion of shoulder abduction and external rotation.
• Subjects with bilateral/unilateral adhesive capsulitis.

You may not qualify if:

• Recent history of surgery on particular shoulder.
• Patients with rotator cuff tears.
• Rheumatoid and gouty arthritis.
• Tumors of the shoulder region.
• Subjects with acute inflammation.
• Recent shoulder dislocation

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (2)

Riphah Rehabilitation Center

Lahore, Punjab Province, 54000, Pakistan

RECRUITING

DHQ Hospital

Sheikhupura, Punjab Province, 54000, Pakistan

RECRUITING

Related Publications (4)

• Iqbal M, Riaz H, Ghous M, Masood K. Comparison of Spencer muscle energy technique and Passive stretching in adhesive capsulitis: A single blind randomized control trial. J Pak Med Assoc. 2020 Dec;70(12(A)):2113-2118. doi: 10.5455/JPMA.23971.

  PMID: 33475581 BACKGROUND

• Nakandala P, Nanayakkara I, Wadugodapitiya S, Gawarammana I. The efficacy of physiotherapy interventions in the treatment of adhesive capsulitis: A systematic review. J Back Musculoskelet Rehabil. 2021;34(2):195-205. doi: 10.3233/BMR-200186.

  PMID: 33185587 BACKGROUND

• Gutierrez Espinoza HJ, Pavez F, Guajardo C, Acosta M. Glenohumeral posterior mobilization versus conventional physiotherapy for primary adhesive capsulitis: a randomized clinical trial. Medwave. 2015 Sep 22;15(8):e6267. doi: 10.5867/medwave.2015.08.6267. English, Spanish.

  PMID: 26485477 BACKGROUND

• Agarwal S, Raza S, Moiz JA, Anwer S, Alghadir AH. Effects of two different mobilization techniques on pain, range of motion and functional disability in patients with adhesive capsulitis: a comparative study. J Phys Ther Sci. 2016 Dec;28(12):3342-3349. doi: 10.1589/jpts.28.3342. Epub 2016 Dec 27.

  PMID: 28174448 BACKGROUND

MeSH Terms

Conditions

Bursitis

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Officials

• Saima Zahid, PhD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Saima Zahid, PhD*

CONTACT

03334349520; Saima.zahid@riphah.edu.pk

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: SPONSOR

Study Record Dates

• First Submitted: April 21, 2022
• First Posted: April 26, 2022
• Study Start: April 25, 2022
• Primary Completion: December 25, 2022
• Study Completion: January 10, 2023
• Last Updated: June 16, 2022

Record last verified: 2022-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (2)