Comparison of anterior versus posterior glide mobilisation techniques for improving internal rotation range of motion in shoulder adhesive capsulitis

OBJECTIVE:

With respect to physical therapy, a variety of interventions are used in which passive mobilization techniques are an important part of the intervention. Traditionally, Physical therapists have used anterior glide of humeral head on glenoid, as a technique to improve external rotation and posterior glide of humeral head to improve internal rotation, a choice based on convex-on-concave concept of joint surface motion. In Contrast, posterior directed glide manipulation is being used by many authors based on “capsular constraint mechanism” to restore external as well as internal rotation ranges. Till date,there was no convincing studies comparing the effect of anteriorly/posteriorly directed glenohumeral joint mobilization techniques in improving internal rotation. Hence, the purpose of this study was to find out effectiveness of anterior and posterior glides techniques for improving internal rotation in shoulder adhesive capsulitis patients.

METHODS:

45 subjects were included for 3 weeks protocol and randomly assigned to three groups (Anterior glide;Posterior glide & Control). Outcome Measures includes Visual Analogue scale Score.(VAS),Active Internal & External rotation and abduction range of motion and. Shoulder Rating Questionnaire Score (SRQ). Data was analyzed using SPSS–15 software. One way ANOVA was applied to compare pain intensity using VAS and to compare Active Int. Rot, Active Ext. Rot, Active Abduction between the groups. Mann–Whitney test was used to analyse SRQ scores between the groups.

RESULTS:

At the end of the study, statistically significant improvement in active internal rotation range was found in anterior glide group as compared to other groups. Pain relief was seen in all the three groups but was more in anterior glide group and posterior glide group as compared to control. Final SRQ scores were found to be insignificant between Group A & Group B but was found to be significant when Group A & Group C as well as Group B & Group C were analyzed

CONCLUSION:

Anterior glide techniques given with therapeutic ultrasound and conventional exercises were more efficient in improving internal rotation than posterior glide techniques given in combination with ultrasound and conventional exercises.