Abstract
Introduction
Frozen shoulder is one of the common conditions that we treat in our clinics on daily basis. It is due to restriction of accessory motions in Gleno-Humeral joint that will result in decreased anatomical movements of shoulder joint. It has a specific pattern of movement restriction mainly passive Lateral Rotation, Abduction and Flexion are affected most. Exercises are very effective in treatment, management and prevention of shoulder impairments. .
Objectives
To determine the effectiveness of Maitland vs. Mulligan Mobilization Techniques in Frozen shoulder in terms of Shoulder Pain and Disability (SPADI) Score and Range of motions of Shoulder joint.
Methods
It is a Prospective Randomized Clinical Trial conducted in Department of Physical Therapy Mayo hospital Lahore after the approval of Ethical Review Committee. Patients of either gender having developed frozen shoulder with primary or secondary cause presenting with capsular pattern are included in the study. 40 Subjects (n=40) who fulfill inclusion criteria were selected, by Simple random sampling method using closed envelops, randomly allocated subjects into two groups. In each group 20 patients were included. One group was given Maitland mobilization (Group A) and other was treated with Mulligan mobilization (group B) but both receive conservative exercise plan as well. Both groups also followed conventional exercises till 6 weeks and shoulder range of motions and SPADI Questionnaire parameters were recorded at the beginning and at the end of 6th week visit of the patients. Analysis was done using SPSS.
Results
Total 40 patients (8 males and 32 females) participated in this study. Mean age of group A patients was 52.80 years and means age of group-B was 53.60 years. Patients in group A were treated with Maitland mobilization technique along with exercises and group B were treated with Mulligan mobilization technique along with exercises. Improvements in Shoulder range of motions are observed in both groups i.e. Group A External Rotation improves from 51.25 to 64.45, Abduction from 86.45 to 107.80 and Flexion from 90.50 to 109.05 while in group B External Rotation improves from 51.80 to 72.20, Abduction from 90.55 to 128.85 and Flexion from 96.75 to 134.50. Both groups show improvements in range of motions but Group B improvements in ROMS are much higher than Group A. SPADI Score also shows significant reduction in case of Group B from 82.45 to 68.50 while in Group A it reduces from 86.75 to 76.45. Both intervention reduces the SPADI score significantly but group B values are much higher reduced.
Conclusion
Improvements in Range of motions and Reductions in SPADI score are high in Mulligan Group.so it is more effective than the other technique.