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Scapular mobilization versus mobilization with movement with low grade mobilization in the treatment of phase II adhesive capsulitis
Zaghloul HMS, Ali HA, Mohamed MT
NeuroQuantology 2022;20(16):3250-3254
clinical trial
3/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Gleno-humeral joint mobilization has been used as an effective intervention for adhesive capsulitis. Decreasing the intra articular pressure is a big challenge specially during phase II of the disease, Therapists typically mobilize the joint capsule and surrounding soft tissue to improve range of motion, lessen the guarding effect, thus break the cycle of pain. Mobilization with movement (MWM) is a technique used to increase range of motion (ROM), typically in peripheral joints, by applying a continuous 'gliding' manual approach in conjunction with contemporaneous physiologic motion of the joint involved, whether passively by the therapist or actively by the subject. Up to now, scapular mobilization used for enhancing the scapular synchronized movement if it is affected by any chance. So far there is no study been done evaluating adding one of the last two techniques to the standard gleno-humeral mobilization might it helps shortening the time of the treatment or gaining more gains. METHODS: In this study, 36 patients with a diagnosis of adhesive capsulitis (stage II) were randomly divided into two groups. Mobilization with movement techniques was provided to Group A. In the second group, participants were treated with a scapular mobilization technique. Standard grade II mobilization was administered to both groups. There are 18 people in each of the two groups. In all groups, participants received 20 minutes of heat therapy using hot packs and standard techniques. This treatment lasted for six weeks and consisted of three sessions per week. Before and after finishing therapy, patients' range of motion in the affected joint was assessed with a goniometer, the SPADI pain score was used to figure out how bad the pain was. Result: The existing study showed that after 3 weeks of treatment, patients in group A (MWM) had substantially lower SPADI pain scores (mean 44.00, AR Flexion scores (mean 02.24), and AROM-GH-External rotation scores (mean 46.08) compared to patients in group B (SM) (mean = 54.00, 81.00, 35.84). was a substantial difference in ROM (%), AROM-GH-Flexion also AROM-GH-External rotation who were treated in group B (SM) with mean being 44.00, 102.24 and 46.08 respectively when compared to group A(MWM) with mean being 54.00, 81.00 and 35.84 in 4 weeks. CONCLUSION: Upon the result, mobilization with movement has a great effect in reducing the pain intensity if used in addition to the standard protocol. On the other hand, Scapular Mobilization will be a great addition if the clinicians aiming to gain extensive ROM in a shorter period than the planned. In any case, the results of the study provided further evidence in favor of using grade II mobilization as part of routine physical therapy treatment for adhesive capsulitis of the shoulder.

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