Effectiveness of shoulder mobilization combined with muscle energy technique in the management of adhesive capsulitis: A randomized control trial

Abstract

Background: Adhesive capsulitis is a debilitating condition characterized by a gradual, painful loss of shoulder motion. As a part of physical therapy programs, mobilization techniques are an important part of the intervention. However, the potential utility of mobilization along with other interventions under supervision is not explored, especially compared to home program exercises. Aim: The objective of the study was to compare the effects of the combination of Maitland’s mobilization protocol and muscle energy techniques (METs) with self-directed nonsupervised general home exercise program (HEP) in frozen shoulder patients. Methods: A total of 24 subjects (14 females and 10 males) were randomized into mobilization with supervised exercise therapy (MSE) group (n = 12) and HEP group (n = 12). Subjects in the MSE group were given Maitland’s mobilization technique and MET for 3 sets (10 glides per set), 3 times/week for 6 weeks, and nonsupervised general HEP for the HEP group. Pain intensity and range of motions (ROMs) of the shoulder were measured for both the groups at the completion of the study duration. Results: Both the groups showed alleviation in pain, but a significant improvement was found in the MSE group than the HEP group. The within-group study showed that ROM was improved in flexion, abduction, external rotation (ER), and internal rotation in the two groups; however, the percentage change was higher in the MSE group than in the HEP group. Significant group effect (P = 0.041 and P = 0.009), time effect (P < 0.001 and P < 0.001), and group × time effects (P < 0.001 and P < 0.001) were found for flexion and ER ROM. Conclusions: A supervised protocol that includes mobilization and other exercises can be an alternative protocol used for the treatment of frozen shoulder without profound adverse effects.