Effectiveness of Scapular Mobilisation in the Management of Patients with Frozen Shoulder- A Randomised Control Trial YC05-YC09
Dr. S Arul Pragassame,
Assistant Professor, Department of Physical Medicine and Rehabilitation, Rajah Muthiah Medial College and Hospital, Annamalai University, Tamil Nadu, India.
Introduction: Frozen shoulder is a condition of uncertain etiology characterised by progressive loss of both active and passive range of motion in the Glenohumeral (GH) joint. It is clear that the GH joint and the scapula do not function independently. Obviously, dysfunction in either joint has a direct impact on the other. Reverse scapulohumeral rhythm means that the scapula moves more than the humerus and it is evident with frozen shoulder. Current manual therapies for the frozen shoulder focus primarily on GH joint mobilisation. Very few studies have addressed the scapular restriction.
Aim: To evaluate the effectiveness of scapular mobilisation in patients with frozen shoulder by comparing with conventional treatment.
Materials and Methods: A total of 30 subjects with frozen shoulder were selected based on the selection criteria. The participants were then randomly allocated into two groups A and B. Group A were given wax therapy, capsular stretching, scapular mobilisation and home exercises and Group B were given wax therapy, capsular stretching, home exercises. Pain, Range of motion (ROM) and functional disability was measured using a Numerical Pain Rating Scale (NPRS), universal goniometer and shoulder constant score for both the groups. The two groups received therapy for five days in a week for two weeks. Pre and post treatment evaluation were compared and statistically analysed.
Results: Group A had significant improvement in NPRS (Z=4.39, p=0.001), shoulder abduction (Z=3.51, p=0.001), shoulder external rotation (Z=4.08, p=0.001) and shoulder constant score (Z=5.39, p=0.001) when compared to group B.
Conclusion: Both the treatment approaches are effective in reducing pain, improving ROM and functional disability in patients with frozen shoulder. However the patients who received scapular mobilisation had significantly higher improvement than the control group.