Effects of Scapular Proprioceptive Neuromuscular Facilitation Techniques in Addition to Routine Physical Therapy on Clinical Outcomes in Patients with Adhesive Capsulitis: A Randomized Controlled Trial

Abstract

Background: Adhesive capsulitis is a painful condition comprises of reduced glenohumeral joint movement and the scapular neuromuscular facilitation techniques is considered effective, non-invasive approach for treating this condition. Objective: To compare the effects of neuromuscular facilitation techniques on clinical outcomes in patients with adhesive capsulitis. Methods: This trial was registered in ClinicaTrials.gov (ref: NCT05151783) and approval was taken (IRB No. 818-II). This single-blinded randomized controlled trial was conducted on patients (n=96) having adhesive capsulitis in six months. Non-probability purposive sampling technique was used for randomization via sealed envelope method. Conventional group received routine physiotherapy including ultrasound, hot packs, shoulder range of motion, stretching exercises, and joint mobilization five times per week for four weeks with 40 minutes’ duration of each session. Glenohumeral joint distraction, caudal, dorsal, and ventral glides were given at a rate of 2-3/second oscillations for 1-2 minutes to patients. Visual analogue scale, functional activity was calculated at baseline, 2^nd and 4^th week. The descriptive statistics (continuous variables) values for each variable in form of means and standard deviations were calculated and their p-values were also calculated using an independent sample t-test. For the qualitative data (categorical variables), frequency and percentage were estimated. Frequencies and percentages of different variables like gender had also been calculated. Repeated measure analysis of variance (ANOVA) was calculated to calculate within-group differences in the mean of each variable between the assessment points. Results: Test of within subject effects showed significant difference for all variables at follow-up and difference between groups also showed significant difference at different follow-ups (p-value≤0.001). Both groups showed statistically significant results (p≤0.001), but scores were higher in experimental group. Conclusion: Scapular proprioceptive neuromuscular facilitation technique along with routine physical therapy are more effective as compared to routine physical therapy alone in patients with adhesive capsulitis.