Effects of Thoracic Mobilisation in Addition to Routine Physical Therapy on Pain, Range of Motion and Functional Disability in Patients with Frozen Shoulder
DOI:
https://doi.org/10.55735/37ahde75Keywords:
Adhesive capsulitis, Functional disability, Range of motion, Thoracic mobilisationAbstract
Background: Adhesive capsulitis or frozen shoulder is a prevalent musculoskeletal condition characterised by limited shoulder joint mobility, pain, and functional impairment. While the conventional physical therapy is the standard approach for managing this condition. Objective: To assess the effects of thoracic mobilisation combined with traditional physical therapy on pain intensity, shoulder range of motion, and functional limitations in patients with adhesive capsulitis. Methodology: This trial was conducted at the Punjab Medical Centre and the University Teaching Hospital, Lahore, Pakistan, in nine months. About 38 patients suffering from adhesive capsulitis with a minimum duration of three months, aged between 45 to 65 years, both genders were recruited in this study. Individuals diagnosed with congenital deformities, cardiovascular diseases, rotator cuff tears, neurological disorders, thoracic outlet syndrome, diabetes mellitus, any rheumatologic condition, cervical radiculopathy, or a history of fractures or tumours were excluded. Participants were randomly assigned to one of two equal groups to ensure unbiased comparison between the interventions by employing computer-generated random numbers, one of which was the physiotherapy group, and the other was the joint mobilisation and physiotherapy group. A paired sample t-test was employed to determine whether there is a statistically significant difference between the means of the two related groups, while an independent t-test was employed to compare the means of two independent groups. Results: The experimental group experienced significantly greater reductions in pain, enhancements in shoulder abduction and external rotation, and improvements in functional ability compared to the control group. Statistical analysis revealed that these differences were significant (p<0.001) and were maintained at the three-month follow-up evaluation. Conclusion: The addition of thoracic mobilisation to conventional physical therapy yields superior outcomes in reducing pain and disability and improving mobility in patients with adhesive capsulitis.
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1. Kingston K, Curry EJ, Galvin JW, Li X. Shoulder adhesive capsulitis: epidemiology and predictors of surgery. Journal of Shoulder and Elbow Surgery 2018; 27(8): 1437-43. https://doi.org/10.1016/j.jse.2018.04.004
2. Haik MN, Alburquerque-Sendín F, Camargo PR. Short-term effects of thoracic spine manipulation on shoulder impingement syndrome: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation 2017; 98(8): 1594-605. https://doi.org/10.1016/j.apmr.2017.02.003
3. Georgiannos D, Markopoulos G, Devetzi E, Bisbinas I. Adhesive capsulitis of the shoulder. Is there consensus regarding the treatment? A comprehensive review. The Open Orthopaedics Journal 2017; 11: 65. doi: 10.2174/1874325001711010065
4. Yeo SM, Lim JY, Do JG, Lim J-Y, In Lee J, Hwang JH. Effectiveness of interactive augmented reality-based telerehabilitation in patients with adhesive capsulitis: protocol for a multi-center randomized controlled trial. BMC Musculoskeletal Disorders 2021; 22: 1-9. DOI: https://doi.org/10.1186/s12891-021-04261-1
5. Shang X, Zhang Z, Pan X, Li J, Li Q. Intra‐articular versus subacromial corticosteroid injection for the treatment of adhesive capsulitis: a meta‐analysis and systematic review. BioMed Research International 2019; 2019(1): 1274790. https://doi.org/10.1155/2019/1274790
6. Ulger O, Demirel A, Oz M, Tamer S. The effect of manual therapy and exercise in patients with chronic low back pain: Double blind randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation 2017; 30(6): 1303-9. https://doi.org/10.3233/BMR-169673
7. Sathe S, Khurana SK, Damke U, Agrawal PV. To compare the effects of maitland mobilization with conventional physiotherapy in adhesive capsulitis. International Journal of Current Research and Review 2020. DOI: http://dx.doi.org/10.31782/IJCRR.2020.99102
8. Chan HBY, Pua PY, How CH. Physical therapy in the management of frozen shoulder. Singapore Medical Journal 2017; 58(12): 685. DOI: 10.11622/smedj.2017107
9. Bizzarri P, Buzzatti L, Cattrysse E, Scafoglieri A. Thoracic manual therapy is not more effective than placebo thoracic manual therapy in patients with shoulder dysfunctions: A systematic review with meta-analysis. Musculoskeletal Science and Practice 2018; 33: 1-10. https://doi.org/10.1016/j.msksp.2017.10.006
10. da Silva AC, Santos GM, de Godoy Marques CM, Marques JLB. Immediate effects of spinal manipulation on shoulder motion range and pain in individuals with shoulder pain: a randomized trial. Journal of Chiropractic Medicine 2019; 18(1): 19-26. https://doi.org/10.1016/j.jcm.2018.10.001
11. Kotagiri S, Mathur N, Balakavi G, Songa AK. The Effectiveness of Muscle Energy Technique and Mobilization to Improve the Shoulder Range of Motion in Frozen Shoulder. International Archives of Integrated Medicine 2019; 6(10). https://search.ebscohost.com/
12. de Araujo FX, Schell MS, Ferreira GE, et al. Autonomic function and pressure pain threshold following thoracic mobilization in asymptomatic subjects: A randomized controlled trial. Journal of Bodywork and Movement Therapies 2018; 22(2): 313-20. https://doi.org/10.1016/j.jbmt.2017.09.005
13. Jahangir S, Naz H, Abid F, et al. Effects Of Thoracic Manipulation in Increasing Rom and Pain in Frozen Shoulder Randomized Control Study: Thoracic Manipulation in Increasing Rom and Pain in Frozen Shoulder. Pakistan BioMedical Journal 2022: 70-3. doi: 10.12669/pjms.37.4.3874
14. Chitroda JV, Heggannavar A. Effect of thoracic and rib manipulation on pain and restricted shoulder mobility in subjects with frozen shoulder: A randomised clinical trial. Indian Journal of Health Sciences and Biomedical Research 2014; 7(2): 92-9. DOI: 10.4103/2349-5006.148807
15. Brindisino F, Turgut E, Struyf F. Frozen shoulder: exploration of terminology and classification. Frontiers in Rehabilitation Sciences 2024; 5: 1498263. https://doi.org/10.3389/fresc.2024.1498263
16. Balu SK, Siva S, Ramachandran A. Need for including Hand Eye Coordination and Hand Function Training in the Management of Adhesive Capsulitis–A non-randomized control trial. Pakistan Journal of Medical Sciences 2022; 38(3). DOI: https://doi.org/10.12669/pjms.38.3.5153
17. Pérez-De La Cruz S, de León ÓA, Mallada NP, Rodríguez AV. Validity and intra-examiner reliability of the Hawk goniometer versus the universal goniometer for the measurement of range of motion of the glenohumeral joint. Medical Engineering & Physics 2021; 89: 7-11. https://doi.org/10.1016/j.medengphy.2021.01.005
18. Alloun Y, Azzaz MS, Kifouche A. A new approach based on artificial neural networks and chaos for designing deterministic random number generator and its application in image encryption. Multimedia Tools and Applications 2024: 1-36. DOI: https://doi.org/10.1007/s11042-024-19136-5
19. El Melhat AM, Abbas RL, Zebdawi MR, Ali Ismail AM. Effect of adding thoracic manipulation for the management of patients with adhesive capsulitis: a randomised clinical trial. Physiotherapy Theory and Practice 2025; 41(1): 65-78. https://doi.org/10.1080/09593985.2024.2316897
20. BILAL U, KHALID M, ANWAR K, ARSHAD H, AHMED U. Additional effects of Thoracic manipulation on pain, shoulder disability and range of motion in patients with Adhesive Capsulitis. Pakistan Journal of Medical & Health Sciences DOI:https://doi.org/10.53350/pjmhs2115123333
21. Hua A. The Effects of Thoracic Spine Thrust Manipulation in Modulating Shoulder Pain and Dysfunction in Patients with Adhesive Capsulitis: 2018.
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