A Comparative Study to assess the effectiveness of Soft Tissue Mobilization Preceding Joint Mobilization Technique in the Management of Adhesive Capsulitis

Abstract

Background: Adhesive capsulitis is a condition wherein the shoulder capsule of the glenohumeral joint becomes inflamed and stiff along with adhesion formation. Mobilisation techniques and soft tissue manipulations are important interventions in the management. Both, soft tissue manipulation and joint mobilisation are proven to be effective in treatment of adhesive capsulitis in the past. However logical thinking warranted the need to study the effects of prior use of soft tissue mobilisation of the periarticular structures, which primarily get affected in adhesive capsulitis, followed by joint mobilisation techniques around the glenohumeral joint. Thus our study compared the efficacy of treatment strategies to improve the extensibility of soft tissues i.e; Myofascial release Armpull technique and Maitland's joint mobilization technique in patients with adhesive capsulitis. Aim: To study the effects of Maitland's mobilization when preceded by Myofascial Release Arm pull technique in patients with Adhesive capsulitis. Methodology: 30 subjects fulfilling the inclusion criteria were selected and randomly allocated into 2 Groups, Group I: Control Group - Maitland's mobilization + Exercises, Group II: Experimental Group - MFR Arm pull + Maitland's mobilization + Exercises. Brief assessment of Pain, Disability and Range of motion was done by using Visual Analogue Scale, Goniometric measurements and Shoulder Pain And Disability Index. Results: Statistical analysis showed significant improvement in pain reduction, functional ability and ROM in both Group 1 and Group 2. However when all the outcome measures were compared between the 2 Groups, significant difference was observed in Myofascial release Arm pull technique preceding Maitland's mobilization with respect to pain, function and ROM. Conclusion: Soft tissue mobilization comprising of Myofascial release Arm pull technique when given prior to Maitland's mobilization showed significant results in reducing symptoms as well as improving functional abilities in Adhesive capsulitis.