Comparative Evaluation Of Efficacy Of Spencer Technique Kaltenborn Mulligan And Maitland Mobilization On Pain Range Of Motion And Functional Disability In Patients With Frozen Shoulder A Four Arm Parallel Randomized Trial

Abstract

Abstract newlineFrozen shoulder is a condition marked by a gradual and painful loss of active and passive shoulder motion due to the thickening and hardening of the joint capsule and adhesions in the intraarticular space. This condition is characterized by an unknown cause that leads to a slow and progressive restriction of all joint motions, which can spontaneously restore partial or complete motion over time, often taking months or years to resolve. An increased prevalence of musculoskeletal problems affecting hand and shoulder is recognized in type II diabetes which is likely to cause major limitations in activities of daily living. The prevalence of frozen shoulder affecting the general population is estimated to be 2-5% and upto 20% in patients with diabetes. Current available treatment methods for managing frozen shoulder are manual therapy techniques namely maitland, kaltenborn, mulligan mobilizations. This study assessed the effect of spencer technique, kaltenborn, mulligan, and maitland mobilization on pain, range of motion and functional independence in frozen shoulder patients. The patients were randomly allocated into four groups namely group A (spencer), group B (kaltenborn), group C (mulligan), and group D (maitland). The baseline assessment was performed on day one, second assessment was performed post three weeks of interventions, follow-up assessment were performed at the end of second month, third month, sixth month for all outcome measures, namely visual analogue scale (VAS) for intensity of pain, shoulder range of motion, and shoulder pain and disability index (SPADI) for functional capacity. A total of 80 frozen patients were recruited for the study and allocated into four groups using computer-generated randomization. Group A underwent spencer protocol; Group B received kaltenborn mobilization protocol, Group C underwent mulligan mobilization protocol, Group D underwent maitland mobilization protocol. All the groups received hot moist fomentation to the painful shoulder and codman s exercises, whic