Effect of Mobilization with Movement versus Diclofenac Phonophoresis on Shoulder Adhesive Capsulitis, MAHA F. SAYED EL SAWABEY, WADIDA H. ELSAYED, ASHRAF N. MOHARRAM and DALIA M. MOSAAD
Abstract
Background: Adhesive capsulitis is a common cause of shoulder pain and disability. It is characterized by spontaneous onset of shoulder pain accompanied by progressive limitation of both active and passive glenohumeral movement. Mobili-zation with Movement (MWM) and diclofenac phonophoresis are of the most effective management techniques of adhesive capsulitis in decreasing pain and improving range of motion. After the application of MWM the pain is reduced. Also Ultrasonic relieves pain and stiffness. Adding NSAID gives additional pain relief. Aim of Study: To compare the effect of MWM technique versus diclofenac phonophoresis on pain intensity level and shoulder range of motion in patients with shoulder adhesive capsulitis. Design of Study: Randomized control trial, pre-test post-test design was used. Method: Thirty-six patients were recruited according to power analysis, were divided randomly into three groups. All groups received conventional physical therapy program for four weeks Group (A): 14 patients received conventional physical therapy only; while in Group (B): Diclofenac pho-nophoresis was added three times per week for 11 patients, and in Group (C): MWM technique was added twice per week for 11 patients. Numerical pain rating scale was used to measure the pain intensity level and saunders digital incli-nometer was used to measure the shoulder range of motion. Results: There was statistical significant difference within the three groups, in decreasing pain intensity score and improving shoulder range of motion. Between groups; there were significant difference in decreasing pain intensity score and increasing shoulder flexion, internal and external rotation. Internal and external rotation were significantly improved favoring MWM in comparison to phonophoresis group, p<0.05. Conclusion: The study concluded that both diaclofenac phonophoresis combined with conventional physical therapy program and MWM had decreased the patient's pain severity and increased the shoulder ROM. But, MWM technique combined with conventional physical therapy program had the superiority in improving the shoulder ROM.