End-range Mobilization Research Articles

SHORT-TERM OUTCOMES OF HOME-BASED AND OUTPATIENT PROGRAMS OF PHYSICAL THERAPY IN PATIENTS WITH FROZEN SHOULDER AND MYOFASCIAL PAIN SYNDROME

The aim: is to compare short-term results of home-based and outpatient programs of physical therapy among patients with frozen shoulder and concomitant thoracic myofascial pain syndrome.
 Materials and methods. The study involved 80 patients. The range of motion in the shoulder joint affected by capsulitis was assessed. A numerical pain scale was used to assess pain sensations when pressing on trigger points. Functional limitations in the shoulder were measured by means of the Oxford Shoulder Score (before and 1.5 months after the end of the physical therapy). Participants were divided into two groups: home-based group (HG) and outpatient group (ОG). All the patients were consulted by a physical therapist. ОG patients received end-range mobilization with the assistance of a physical therapist 5 times a week to improve shoulder joint mobility. Most of ОG participants received 15 procedures (3 weeks). Patients HG performed therapeutic exercises without any assistance at home. (twice a day, 3 weeks). In terms of trigger points therapy, the patients performed ischemic compression without any assistance.
 Results. Patients of both groups demonstrated positive dynamics of the studied indicators. Comparison of the short-term results of the therapy according to range of motion and pain showed better indicators in the ОG. Comparison of the initial results of the groups in Oxford Shoulder Score items did not reveal any significant differences. Total score was 18.2±6.5 points in ОG and 17.6±7.5 points in HG (p=0.715). Me (25%; 75%) values were 17.5 (12.5; 23.8) and 18 (13; 23.5) points, respectively. Comparison of the final results of the groups in Oxford Shoulder Score items revealed significant differences. Total score was 47 (47; 48) points in ОG and 33 (31; 35.75) points in HG (p<0.001). x̅±SD values were 46.5±2.6 and 32.8±4.4 points, respectively.
 Conclusions. Short-term results of the outpatient program in terms of pain indicators, mobility of the shoulder joint and functional limitations were better as compared to the home-based program of physical therapy in patients with frozen shoulder and concomitant thoracic myofascial pain syndrome.

Dynamics of disability and pain indicators under the influence of physical therapy for adhesives capsulitis and myofascial pain syndrome.

Aim: To compare the effectiveness of end-range mobilization and therapeutic exercises, used in combination with ischemic compression, on disability and pain indicators among patients with adhesive capsulitis of the shoulder joint and thoracic myofascial pain syndrome. Materials and Methods: The study involved 68 patients. Goniometry of the shoulder joint, assessment of pain in myofascial trigger points, and the Shoulder Pain and Disability Index questionnaire were used before and after physical therapy. The duration of physical therapy comprised 3 weeks. Physical therapy of the first group of patients consisted of end-range mobilization and ischemic compression. Patients of the second group performed therapeutic exercises and ischemic compression. Results: Both groups demonstrated positive dynamics of shoulder joint mobility, Shoulder Pain and Disability Index and pain in trigger points. However, the final results of the studied indicators were better in the first group of patients. Conclusions: Physical therapy based on the combination of end-range mobilization and ischemic compression had a more positive impact on disability and pain indicators for adhesive capsulitis of the shoulder joint and myofascial pain syndrome as compared to the combination of therapeutic exercises and ischemic compression.

THE INFLUENCE OF MOBILIZATION AND ISCHEMIC COMPRESSION ON PAIN AND DISABILITY IN ADHESIVE CAPSULITIS AND MYOFASCIAL PAIN SYNDROME

The purpose of the study: to investigate the effect of end-range mobilization and ischemic compression on pain and disability scores among patients with adhesive capsulitis of the shoulder joint and myofascial pain syndrome in the thoracic region.
 Materials and methods. Goniometry of the shoulder joint, assessment of pain at the end points of the range of motion and trigger points (when applying a pressure of 2.5 kg×cm-2), as well as the Shoulder Pain and Disability Index questionnaire were used before the intervention and after physical therapy.
 Physical therapy began after an examination and consultation with an orthopedic traumatologist. The majority of patients received 15 planned procedures of end-range mobilization performed by a physical therapist within 3 weeks, only two patients received 14 and 16 procedures. Mobilization from I to V degrees of intensity according to the Maitland classification was used. The patient performed ischemic compression independently after instruction (determination of the localization of trigger points, formation of their map, training in exposure techniques). Compression was performed with an average level of pain or more than average; duration of 30 seconds for each point.
 Results. The proportion of male patients was 20.8%. In the examined group of patients, the values of Me (25%; 75%) for age were 53.5 (48.25; 58.5) years, and for the duration of symptoms 4 (2; 5.5) months. Localization of adhesive capsulitis on the right side was observed in 9 patients (37.5%), and on the dominant upper limb in 8 (33.3%) patients. In five patients, the lesion was on the dominant right limb. The evaluation of the transfer of end-range mobilization procedures at the end of the first, sixth, eleventh and last procedure established that the maximum pain on a 10-point scale during mobilization was, respectively: 10 (9; 10) points, 8 (7.25; 9) points, 7 (5 ; 8) points and 4 (3; 5) points. In the course of physical therapy, the indicators of amplitudes of movements and pain at maximum amplitude, as well as at trigger points, improved statistically. The median value for active abduction increased by 74.5° and for active flexion increased by 116.5°. The median value for active internal rotation increased by 77.5°, and for active external rotation, flexion increased by 75°. The median value of pain when reaching the maximum amplitude of active abduction decreased by 6 points, and for active flexion, internal and external rotation, the median dynamics indicator was similar. It should be noted that the pain index at the trigeminal point at the first assessment was 9 (9; 9) points, and at the final assessment it statistically improved and was 4 (3; 4) points (Z = -4.340; p<0.001). All items of the Shoulder Pain and Disability Index questionnaire improved statistically, leading to improvements in domain values and the index itself. Іndicators Me (25%; 75%) of the pain domain decreased from 93 (63; 100) points to 16 (6.5; 20) points (Z = -4.287; p<0.001), and the disability domain from 83.8 (56.9; 91.6) points to 5.6 (3.8; 10.9) points (Z = -4.286; p<0.001). Тhe median indicator of the pain domain decreased by 77 points, and the disability domain by 78.2 points. The index decreased from 88.7 (54.1; 94.4) points to 10.5 (4.2; 15.4) points. (Z = -4.286; p<0.001).
 Conclusions. The use of a combination of end-range mobilization and ischemic compression was effective in reducing the index of shoulder pain and disability among the examined patients.

Ефективність мобілізації та ішемічної компресії при адгезивному капсуліті та міофасціальному больовому синдромі

The purpose of the study was to investigate the effect of end- range mobilization and ischemic compression on the range of motion and pain scores in patients with adhesive capsulitis of the shoulder joint and myofascial pain syndrome in the thoracic spine. Materials and methods. 20 patients participated in the study. Goniometry of the shoulder joint, pain assessment on a numerical scale at the endpoints of the range of motion and trigger points (when applying a pressure of 2.5 kg×cm-2) were performed before the intervention, at the end of the first week of therapy, at the end of the second and third week. Physical therapy began after an examination and consultation with an orthopedic traumatologist. All patients received intensive end-range mobilization performed by a physical therapist and ischemic compression performed by the patient 5 times a week (3 weeks). Mobilization techniques from I to V degrees of intensity according to the Maitland classification system were used. Localization of active and latent trigger points was determined, their marking was carried out on an individual map, which was provided to the patient. The patient was instructed in techniques and methods of influencing trigger points of various locations. Compression was performed with an average or above average pain level and a duration of 30 seconds for each trigger point. Results and discussion. The existence of differences in the results of the amplitude was established, taking into account the time factor. The median score for active abduction increased by 65.5° and for flexion – by 115.5°. The amplitude of active internal rotation increased by 73°, and external – by 72°. According to Friedman's test, similar results were obtained when comparing pain indicators, which were assessed at the endpoints of the range of motion. The dynamics of medians was from 5 to 6 points. The median trigger point pain score decreased by 5.5 points after three weeks of physical therapy. The results obtained when studying the effectiveness of ischemic compression in patients with adhesive capsulitis of the shoulder joint and myofascial pain syndrome are consistent with the conclusions of previous studies and complement the data presented in the literature. Conclusion. Physical therapy, which consists of a combination of end-range mobilization and ischemic compression, is effective in increasing passive and active range of motion in the shoulder joint, reducing pain at the end of the range of motion, and reducing pain at trigger points

Satisfaction with the Physical Therapy in Patients with Adhesive Capsulitis and Myofascial Pain Syndrome

Aim: To investigate and compare satisfaction with the physical therapy in patients with adhesive capsulitis of the shoulder joint and concomitant thoracic myofascial pain syndrome undergoing outpatient and home programs. Materials and Methods: The study involved 76 participants. Shoulder joint mobility and pain in myofascial trigger points were assessed before and after the physical therapy program. Scale to measure patient satisfaction with physical therapy was used after the program. Patients of both groups received physical therapist consultations. The first group of patients received endrange mobilization (performed by a physical therapist) and performed ischemic compression (without any assistance). The second group of patients performed therapeutic exercises and ischemic compression without any assistance at home. The duration of the program in both groups comprised 3 weeks. Results: Mobility and pain indicators were improved in both groups. However, the results of the second assessment were better in the first group. Physical therapy satisfaction scores were high in both groups, but the first group had statistically better results in four questionnaire items and in the total score. Me (25%; 75%) indicators of the total satisfaction score comprised 85 (84.75; 85) points in the first group and 78 (77.75; 79) points in the second group. Conclusions: The patients who received consultations, end-range mobilization, and performed ischemic compression had a higher level of satisfaction as compared to the patients who attended consultations and performed therapeutic exercises and ischemic compression.

ADDED EFFECT OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION TECHNIQUE WITH MAITLAND MOBILISATION TECHNIQUE IN PERIARTHRITIS OF SHOULDER

Background: Periarthritis of shoulder is a chronic inammatory disorder of shoulder and surrounding soft tissues, characterized by insidious and progressive pain & restriction of both active and passive glenohumeral joint motion in all planes. To assess the effect of Proprioceptive Neuromuscular Facilitati Objective: on & Maitland Mobilisation in Periarthritis of shoulder. To compare the added effect of PNF with Maitland Mobilisation in Periarthritis of shoulder. 30 Patients diagnosed with stage I & II Method: periarthritis of shoulder were included in the study. Group A which is control group received IFT for 10 minutes, hot pack, Maitland grade 3& 4 end range mobilization for shoulder to improve external rotation, abduction, and exion. Group B which is experimental group received same conventional treatment as group A along with PNF technique for 3 weeks. At the end of 3rd week, posttest evaluation comprising of active ROM measurements, strength by taking MMT, & SPADI was taken for both the groups. It was found that ther Results: e was signicant increase in ROM and decrease in SPADI score within both the groups i. e. control and experimental. Study proved Conclusion: that PNF combined with conventional treatment helps to improve range of motion and function of shoulder joint in stage I & II of periarthritis of shoulder. So the technique can be incorporated with the conventional protocol for the management of above condition.

The time curve of a single end-range maitland mobilization on pressure pain threshold and functional outcomes in knee osteoarthritis

Purpose: Peripheral and central sensitization are suggested the two underlying mechanisms of pain in knee osteoarthritis (KOA). Amongst several testing procedures, pressure pain threshold (PPT) measurement is the most sensitive method for investigating the magnitude of peripheral and central sensitization in KOA. While local PPT measurement refers to peripheral sensitization, distant PPT measurement implies central sensitization. The immediate effectiveness of not end-range Maitland mobilization on alleviation of pain perception has been previously confirmed in KOA.

End-Range and Scapular Mobilization Technique Versus PassiveStretching Exercises in Treatment of Shoulder Adhesive Capsulitis

AbstractBackground: Idiopathic adhesive capsulitis of the shoulderis a condition characterized by gradual loss of active andpassive glenohumeral motion. The prevalence of adhesivecapsulitis is estimated to be two to five percent of the generalpopulation. Stretching the adhered shoulder capsule by meansof end range mobilization and passive stretching is the cor-nerstone of physical therapy interventions for treatment ofadhesive capsulitis. Scapular mobilization is also recommendedto correct the abnormal scapulohumeral rhythm accompaniedwith the limited motion at glenohumeral joint in patients withadhesive capsulitis.Aim of Study: To compare between the effect of end rangemobilization and scapular mobilization versus passive stretch-ing exercises on shoulder pain severity, functional disabilityand passive range of motion of shoulder flexion, abduction,internal rotation and external rotation in treatment of idiopathicshoulder adhesive capsulitis.Design of the Study: Randomized clinical trial, pretreat-ment posttreatment design was used.Methods: Forty male patients with idiopathic adhesivecapsulitis of the shoulder, whose age ranged between 40 to65 years with limited shoulder passive range of motion in atleast 2 of 4 directions and duration of illness ranged between 3 and 12 months participated in this study. They were randomly distributed into two equal experimental groups. The first group received end range mobilization technique and scapular mobilization technique and the second group received passive stretching exercises. In addition to that both groups received infrared radiation before each treatment session for warming up. All patients were treated twice weekly for six weeks.Results: Both groups had significant improvement in allmeasured variables. End range mobilization and scapularmobilization was significantly more effective than passivestretching exercises in improving shoulder pain severity,functional disability and range of motion of shoulder flexionand abduction. However, there was no significant differencebetween groups in improving range of motion of shoulderexternal rotation and internal rotation.

EFFECTS OF END-RANGE MOBILIZATION TECHNIQUE ON PAIN AND DISABILITY IN PATIENTS WITH ADHESIVE CAPSULITIS-A QUASI-EXPERIMENTAL STUDY

BACKGROUND AND AIMS Studies have revealed that end-range mobilization techniques are found to be efficient in providing high and low-grade thrusts thereby enhance cellular elongation, decreases soft tissue edema and localized inflammatory changes in the affected individual. Therefore, this study is aimed to determine the effects of end-range mobilization on patients with Adhesive Capsulitis. METHODOLOGY This quasi-experimental study was conducted on 40 patients of 40-70 years of age with adhesive capsulitis. End-range mobilization was performed in 2-3 sets of 10-15 repetitions in Grade 3 or 4 in varying plane and degree of rotation for 2 days/week for 4 weeks for the duration of 30 minutes while the Shoulder Pain and Disability Index (SPADI ) was used to assess pre and post outcomes. RESULTS A total number of 40 adhesive capsulitis patients included in this study with a mean age of 51.2±10.6 consisted of 19 males and 21 females. The overall SPADI scores were significantly decreased to 66.45±8.8 from 73.99±9.1 post-intervention of 4-weeks inclusive the marked reduction in pain and disability scores respectively CONCLUSION It was concluded that the end-range mobilization technique was effective to reduce pain and disability, subsequently SPADI score pre and post 4-weeks of intervention in adhesive capsulitis patients. Further trials should be conducted in the future taking large samples and varied techniques into account for the identification of optimal strategy in improving health-related outcomes of patients with shoulder joint pathologies.

Effects of Anterior Versus Posterior End Range Mobilizations on Shoulder Rotations Range of Motion in Adhesive Capsulitis Stage II

Background: Adhesive capsulitis is characterized by a spontaneous onset of shoulder pain accompanied by progressive limitation of both active and passive glenohumeral joint movements. Aim and Objectives: This study was done to compare effectiveness of anterior versus posterior end range mobilizations on shoulder rotations range of motion (ROM) in subjects with adhesive capsulitis stage II. Method: 56 participants with clinical diagnosis of adhesive capsulitis stage II were randomly allocated in two groups A & B. Both groups received therapeutic ultrasound and pre-set of prescribed home exercises in common. While Group ‘A’ received Anterior and Group ‘B’ received Posterior end range mobilizations. Shoulder rotations ROM was assessed as Outcome measure using universal goniometer at baseline, at end of 2 weeks post intervention. Results: Result showed both anterior (% of change was -66.88) and posterior (% of change was -67.80) end range mobilization were equally effective in increasing internal rotation (IR) ROM. Posterior end range mobilisation (% of change was -187.50) was more effective than anterior end range mobilization (% of change was -101.37) in increasing external rotation(ER) ROM. Conclusion: We concluded that application of posterior end range mobilization is more effective than anterior end range mobilisation in increasing ERROM.

Effectiveness of End Range Mobilization along with conventional therapy in patients with Periarthritis Shoulder

Pain is the most primary symptom in patients with shoulder disorders affecting the soft tissue. In most cases painful restriction of the range of shoulder movements limitis the ability to perfrme daily activities. The cumulative annual incidences of shoulder disorders vary from 7 to 25 per 1000 general consulation. Likewise Periarthritis shoulder is classified as a clinical entity presenting a unique pathology occuring only at the shoulder joint. Periarthritis shoulder is booming out as an are of interest to the orthopaedic surgeons and as well as to the physical therapist. The condition is attributed with pain initially which later on woreses as in ability to do the funcyional activities leading to disability. Indexes of pain, joint range and functional performance were recorded as pre and post test values for a period of 2 weeks. The study shows decreased in the values of NPRS from a mean value of 7.53 to 2.53, improvement of shoulder abduction joint range from mean value of 74.13 to 92.33 and external rotation with a mean value from 28.47 to 46.81 along with improvement of the functional performance from a mean value of 54.99 to 47.44. The shoulder abduction and the external rotation joint range were found to be significant increase with the P value (<0.0001) statistically significant along with improvement of the functional performance with the P value (<0.0001) statistically significant. Thus the study concludes that end range mobilisation along with conventional treatment is more effective in reducing pain with improvement in the joint range and the functional performance. Therefore, the purpose of this study is to assess the efficacy end range mobilisation when added to standard treatment for Periarthritis shoulder.

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

Comparision between the Effectiveness of Mobilization with Movement and End Range Mobilization along with Conventional Therapy for Management of Frozen Shoulder

Comparision between the Effectiveness of Mobilization with Movement and End Range Mobilization along with Conventional Therapy for Management of Frozen Shoulder

Effectiveness of End Range Mobilization in Non Diabetic Frozen Shoulder

Effectiveness of End Range Mobilization in Non Diabetic Frozen Shoulder

Immediate effect of end range mobilization on shoulder range of motion and pain in patients with adhesive capsulitis.

INTRODUCTION: Adhesive capsulitis is a common disease found in India. End range mobilization is effective in improving the Range of motion (ROM). However the immediate effect of End range mobilization is not known. AIMS & OBJECTIVES: Purpose of the study was to know the immediate effect of End range mobilization on shoulder ROM in patients with adhesive capsulitis. METHODOLOGY: Thirty Subjects diagnosed as shoulder adhesive capsulitis were included. Patients who had history of trauma, Rheumatoid arthritis, bilateral shoulder involvement and signs of cervical radiculopathy were excluded. Subjects were randomly distributed into two groups-A and B. Pre and Post ROM was recorded. Group A- End range mobilization was given in caudal and anterior direction. Group B- Control group – sham mobilization was given. For both the groups immediate difference of ROM was measured. OUTCOME MEASURES: ROM measured by goniometry and Visual Analog Scale (VAS) RESULTS: Results were calculated using software SPSS 16. Wilcoxon test was applied for within group and Mann-WhitneyU for between group comparisons. Group A showed significant difference in both ROM and VAS. Group B showed no significant difference for ROM but was significant for VAS. There was significant difference between group A and B for ROM and no significant difference for VAS. CONCLUSION: It can be concluded from the present study that the treatment given to both the groups were effective in reducing pain and effective in improving ROM but group A was found to be better in improving ROM.

THE COMBINED EFFECTIVENESS OF GLENOHUMERAL END-RANGE MOBILIZATION AND CONTRACT-RELAX TECHNIQUE FOR GLENOHUMERAL INTERNAL ROTATORS IN SUBJECTS WITH ADHESIVE CAPSULITIS.

Background: Frozen shoulder is an insidious condition that begins with pain and gradual restriction of movement in the shoulder region. There are various methods of treating frozen shoulder (both surgical and non-surgical).Among the non-surgical methods there is no specific method accepted universally. Purpose of this study is to determine the combined effectiveness of Glenohumeral End-Range Mobilization and Contract-Relax technique for glenohumeral internal rotators in patients with adhesive capsulitis.Methods: 60 frozen shoulder patients randomized 30 subjects into each experimental and control group. Group A (experimental group) received Glenohumeral End-Range Mobilization, Contract-Relax Technique for glenohumeral internal rotators and Shoulder Pendular Exercises 2 times a week for a period of 4 weeks (8 sessions).Group B (control group) received Shoulder Pendular exercises 2 times a week for a period of 4 weeks (8 sessions). Outcome measures included are VAS, SPADI and goniometry for assessing pain, functional ability and ROM for the shoulder joint.Results: The average improvement of VAS for Group A and Group B were 4.5 and 3 respectively using median. The U-value was 176, which is statistically highly significant (p value = 0.000).The average improvement of Shoulder Pain and Disability Index for Group A and group B were 56.9333 and 10.3667 respectively using mean and Standard Deviation. The t-value was 35.91181, which is statistically highly significant (p value = 0.000).Conclusion: The results indicated that both Group A and Group B had significant improvement in the scores of VAS, SPADI and GONIOMETRY scores at the 4th week when compared to base line values, but when comparing the end results of group A and group B it has been found out that group A intervention is more effective then Group B in treating the internal rotators of patients with adhesive capsulitis

MULLIGAN MOBILIZATION IS MORE EFFECTIVE IN TREATING DIABETIC FROZEN SHOULDER THAN THE MAITLAND TECHNIQUE

Background:&nbsp;Patients with frozen shoulder suffer from significant pain and progressive limitation of shoulder active and passive movements. Such clinical problems are primarily treated conservatively. Physical therapy is an integral part in treatment of frozen shoulder. Rehabilitation may include various manual mobilization techniques in order to relieve pain and restore mobility and function. Therefore, this study aimed at comparing the effects of two different mobilization techniques (Mulligan Mobilization with Movement and Maitland end range mobilization) on improving shoulder pain, function and mobility in patients with diabetic frozen shoulder.Methods:&nbsp;Thirty patients were randomly and equally distributed into two groups: (1) Mulligan group receiving mobilization with movement, and (2) Maitland group receiving end range oscillatory mobilization. Treatment was given 3 times per week, for 6 consecutive weeks. Patients were evaluated before and after treatment with regards to shoulder pain severity and functional disability using the Shoulder Pain and Disability Index as well as for shoulder flexion, abduction, external and internal rotation range of motion using a digital level inclinometer.Results:&nbsp;Patients in the two groups showed significant improvement in all the measured variables over the treatment period (p&lt;0.01), however, patients who received the Mulligan technique showed greater improvement (p&lt;0.05). Between group comparisons showed that patients in the Mulligan group significantly improved than those in the Maitland on all measured variables (p&lt;0.05), except for the internal rotation range of motion (p&gt;0.05).Conclusion:&nbsp;Mulligan and Maitland end range mobilization are effective in decreasing shoulder pain and dysfunction as well as in increasing shoulder mobility in all directions. However, the Mulligan mobilization is more effective when treating patients with diabetic frozen shoulder.

Immediate effects of an end-range mobilization technique on shoulder range of motion and skin temperature in individuals with posterior shoulder tightness.

[Purpose] This study investigated the effects of an end-range mobilization technique on the range of motion of the glenohumeral internal rotation and the skin temperature of the shoulder in individuals with posterior shoulder tightness. [Subjects] Thirteen subjects with posterior shoulder tightness who had glenohumeral internal rotation deficit ≥ 15° participated. [Methods] All subjects underwent glenohumeral joint end-range mobilization intervention. The internal rotation range of motion of the glenohumeral joint was measured by a goniometer and the shoulder skin temperature was measured by a digital infrared thermographic imaging device before and immediately after the intervention. Paired t-tests were used to analyze the differences in these parameter pre and post-intervention. [Results] The glenohumeral internal rotation range of motion and skin temperature of the posterolateral shoulder in increased significantly post-intervention. [Conclusion] The end-range mobilization technique is effective for increasing the glenohumeral internal rotation range of motion and skin temperature of the shoulder in individuals with posterior shoulder tightness.

Combined Effect of End Range Mobilization (ERM) and Mobilization with Movement (MWM) Techniques on Range of Motion and Disability in Frozen Shoulder Patients: A Randomized Clinical Trial

The purpose of the study was to find out the combined effect of end range mobilization and mobilization with movement in patients with frozen shoulder. A total of 30 patients (male=16; female=14) were selected as subjects and they were further divided into 3 groups respectively (Group A=ERM; Group B=MWM; Group C=ERM+MWM). Each group comprising of 10 subjects (Group A & B male=6, female=4; Group C male=4, female=6). The results of the present study suggest that there was an improvement in the mean values of Range of Motion (both active & passive) and Shoulder Pain Disability Index scores after treatment in all the 3 groups. But it was found that an improvement was statistically significant more in the group C than the group A & B respectively. It was concluded that the combination manual therapy (ERM+MWM) should be incorporated in the treatment protocol of frozen shoulder patients to achieve better gain in the ROM & SPADI scores.

A Comparative Study to Find out the effect of Ultrasound with end Range Mobilization Over Cryotherapy with end Range Mobilization on Pain in Frozen Shoulder

Background: Effectiveness of any individualized therapeutic modality in reducing pain in frozen shoulder is questionable and the combination of therapies has contradictory results. Objectives: The purpose of this study was to check the effectiveness of Ultrasound with end range mobilization over Cryotherapy with end range mobilization in alleviating pain of patients with frozen shoulder. Method: Forty subjects diagnosed to have frozen shoulder were randomly assigned to two groups. Subjects in Group I received Ultrasound and End range mobilization of shoulder while subjects in Group II got Cryotherapy and End range mobilization of shoulder. Both the groups were treated once a day, 6 days a week for 4 weeks. Response to pain was considered as the outcome measure. Results: Data analysis was done considering p Conclusion: Ultrasound with end range mobilization produced better pain relief compared to cryotherapy with end range mobilization and therefore can be recommended as a safe treatment for frozen shoulder.