Additional effects of Thoracic manipulation on pain, shoulder disability and range of motion in Adhesive Capsulitis

Abstract

Aim: To determine the additional effects of thoracic manipulation on shoulder pain, shoulder range of motion (ROM) and disability in combination with conventional physical therapy exercises for individuals with adhesive capsulitis. Materials: A parallel, randomized controlled clinical trial was conducted. 32 patients (16 in each group), aged between 40‑60 years from both genders having shoulder pain, clinically diagnosed with adhesive capsulitis (Stage II and III), along with thoracic spine hypo mobility were included. Patients were randomized into conventional physiotherapy group (A) and thoracic manipulation group (B). Clinical trial was continued for two weeks with three sessions per week and a follow up was done at the end of 3rd week. Visual analogue scale (VAS), shoulder range of motion (ROM) and Disabilities of Arm Shoulder and Hand (DASH) score were used for outcomes measurement. Results: Intragroup comparison for shoulder ROM, DASH and VAS scores shows a significant (p value=≤0.001) for both groups. Intergroup comparison for shoulder ROM was improved significantly on post-intervention (p value=≤0.001). While intergroup comparison of baseline to end value for VAS showed insignificant result (p value=0.373). Conclusion: Additional effects of thoracic manipulation to conventional physical therapy underwent a greater improvement regarding shoulder range of motions and disability. Conventional physical therapy exercises and a combination of thoracic manipulation to conventional physical therapy exercises are equally effective for decreasing shoulder pain. Keywords: Adhesive Capsulitis, Pain, Frozen shoulder, Physical Therapy, Rehabilitation