Effectiveness of Mobilization with Movement with and without Therapeutic Ultrasound in Rehabilitation of Idiopathic Adhesive Capsulitis

Background: Frozen shoulder syndrome is clinically known as adhesive capsulitis, is a painful and debilitating condition causing fibrosis of the glenohumeral joint capsule with a chronic inflammatory response. Patients experience pain, limited range of motion and disability generally lasting anywhere from 1 to 24 months. There is a lack of evidence about the effectiveness of therapeutic ultrasound (US) with mobilization with movement compared with mobilization with movement and without movement (US) in the treatment of adhesive capsulitis. Objective: To determine the effectiveness of mobilization with movement with and without therapeutic ultrasound in rehabilitation of idiopathic adhesive capsulitis. Methodology: The single blinded randomized control trial was conducted on 50 patients in the out-patient physical therapy and rehabilitation department of Maroof International Hospital Islamabad and patients with idiopathic adhesive capsulitis having pain for at least 1 month, not able to lie on the affected side at night and both active and passive motion restricted in flexion, abduction and external rotation, were randomly selected and placed into two groups. The MWM with therapeutic ultrasound were applied in group A, while MWM alone in group B. The study variable were pain score on visual analogue scale (VAS), active range of motion (AROM) of shoulder flexion, abduction and external rotation and were compared at baseline and at completion on plan of care after six months. Data was analyzed on SPSS and statistical tests were applied to determine the probability at 95% level of significance. Results: fifty patients with adhesive capsulitis were enrolled and placed randomly into two groups, the base line characteristics were similar in both groups, six week after intervention, patients with group A had more improvement in pain score (0.000), active range of abduction (0.001), external rotation (0.000), internal rotation (0.000) and functional activity (0.037) as compared to group B. In group B improvement was less in pain score (0.010), active range of abduction (0.591), external rotation (0.001), internal rotation (0.01) and functional activity (0.081) as compared to group A. Conclusion: Ultrasound with movement with mobilization produced a better result therefore can be recommended in the treatment of idiopathic adhesive capsulitis of shoulder.