End-Range and Scapular Mobilization Technique Versus PassiveStretching Exercises in Treatment of Shoulder Adhesive Capsulitis

Background: Idiopathic adhesive capsulitis of the shoulderis a condition characterized by gradual loss of active andpassive glenohumeral motion. The prevalence of adhesivecapsulitis is estimated to be two to five percent of the generalpopulation. Stretching the adhered shoulder capsule by meansof end range mobilization and passive stretching is the cor-nerstone of physical therapy interventions for treatment ofadhesive capsulitis. Scapular mobilization is also recommendedto correct the abnormal scapulohumeral rhythm accompaniedwith the limited motion at glenohumeral joint in patients withadhesive capsulitis.Aim of Study: To compare between the effect of end rangemobilization and scapular mobilization versus passive stretch-ing exercises on shoulder pain severity, functional disabilityand passive range of motion of shoulder flexion, abduction,internal rotation and external rotation in treatment of idiopathicshoulder adhesive capsulitis.Design of the Study: Randomized clinical trial, pretreat-ment posttreatment design was used.Methods: Forty male patients with idiopathic adhesivecapsulitis of the shoulder, whose age ranged between 40 to65 years with limited shoulder passive range of motion in atleast 2 of 4 directions and duration of illness ranged between 3 and 12 months participated in this study. They were randomly distributed into two equal experimental groups. The first group received end range mobilization technique and scapular mobilization technique and the second group received passive stretching exercises. In addition to that both groups received infrared radiation before each treatment session for warming up. All patients were treated twice weekly for six weeks.Results: Both groups had significant improvement in allmeasured variables. End range mobilization and scapularmobilization was significantly more effective than passivestretching exercises in improving shoulder pain severity,functional disability and range of motion of shoulder flexionand abduction. However, there was no significant differencebetween groups in improving range of motion of shoulderexternal rotation and internal rotation.