Manual Therapy Interventions in Adhesive Capsulitis: A Tri-Modal Comparison
Keywords:
adhesive capsulitis, frozen shoulder, manual therapy, glenohumeral manipulation, mobilization with movement, myofascial releaseAbstract
Adhesive capsulitis (AC), commonly known as frozen shoulder, is a debilitating condition characterized by progressive loss of shoulder mobility and significant pain. The condition affects 2-5% of the general population and poses substantial challenges for effective treatment approaches. This study aimed to compare the effectiveness of three manual therapy interventions in patients with adhesive capsulitis: glenohumeral gliding manipulation (GM), mobilization with movement (MWM), and myofascial release therapy (MRT). A prospective comparative study was conducted with 120 participants diagnosed with primary adhesive capsulitis. Participants were randomly allocated to three groups (n=40 each): GM group, MWM group, and MRT group. Primary outcomes included range of motion (ROM), pain intensity (VAS), and functional disability (SPADI). Secondary outcomes assessed sleep quality and quality of life measures. Assessments were conducted at baseline, 4 weeks, 8 weeks, and 12 weeks post-intervention. All three interventions demonstrated significant improvements in primary outcomes. The GM group showed superior improvements in external rotation ROM (45.2° vs 38.1° and 36.7°, p<0.001). The MWM group demonstrated the greatest reduction in pain intensity (VAS reduction: 4.8 vs 4.2 and 4.1, p<0.01). The MRT group showed optimal improvements in sleep quality scores (PSQI improvement: 5.2 vs 4.1 and 3.9, p<0.05). Manual therapy interventions are effective for treating adhesive capsulitis, with each modality showing distinct advantages. Glenohumeral gliding manipulation excels in restoring ROM, MWM provides superior pain relief, and myofascial release therapy optimally improves sleep quality and overall quality of life.
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